I'm lucky enough to have remote work. And I'm sure many HNers have a nice buffer of savings from their tech jobs to weather the storm or are getting paid time off.
But can anyone share what it's like to not be in either of these situations? How are your rent lords handling things?
I live abroad in a cheap country so I can handle zero income, but I wouldn't be able to last long if rent was $2000+/mo instead of the <$200/mo I currently pay.
Yet when I read Redditors talk about quarantine, you'd think everyone in the world was getting paid time off to play Animal Crossing at home or they live at mom's house rent-free. And it seems like it's this crowd that's likely to be pushing for staying in lockdown with no end in sight.
My friend who works at the airport in the Galapagos (GPS) was telling me that no one has gotten paid since the tourism stopped. Luckily she can work on farm, but many can't. The local animal shelter there is now out of food, and the dogs will starve if they don't somehow raise money in the next 3 days or so (@patitasgalapaguenas on instagram, you can donate here [0]).
The US is struggling in many ways, but I can't help but think many other less fortunate nations are struggling even more. But the US doesn't show international news so you wouldn't really know unless you go looking for it.
Al Jazeera is always a good source for news ignored by the rest of the world. Here's social distancing in a prison in El Salvador -- not sure those masks will help much.
Sure, but the implementation was still absurdly bad. For example, by imposing a harsh lockdown on cities with no plan for migrant workers, the only thing they could do was head home to their villages, ensuring the virus would be distributed widely across the country.
That’s the rational calculus, yes. But humans have a really hard time balancing suffering today against hypothetical suffering tomorrow, especially when successful intervention makes it appear like the problem was never there in the first place.
It's true almost by definition. Actions sufficient to mitigate a low-probability, high-impact event will seem like complete overreaction for people who can't do this calculation - which is most of them. After all, lots of effort and sacrifice happened, and there was no damage!
Can you point to a study about this? In Bayesian terms most people would put the prior probability in favor of his common sense hypothesis. And you just have to Google for "psychology of risk perception" to get a few more studies in favor of it.
Well yes, of course it's rational. Tautologically, hypothetical suffering tomorrow might not happen whereas suffering today actually is happening - in this case we have only the words of essentially discredited 'experts' (epidemiologists), many of whom are constantly bickering in public and pronouncing each others models useless or broken.
And the idea that mass lockdowns can stop the spread of virus is itself a radical, new idea that's never been tried, and which has its own cadre of experts saying it hasn't been working or is making little difference.
Given what we know now, extending a shelter-in-place order through all of May is catastrophic. It will likely trigger mass civil unrest. The virus just isn't that dangerous.
> And the idea that mass lockdowns can stop the spread of virus is itself a radical, new idea that's never been tried, and which has its own cadre of experts saying it hasn't been working or is making little difference.
You probably could say "has not been tried recently", but mass quarantines has been tried since time immemorial.
No. Preventative mass global quarantine has never been tried anywhere. Even quarantines in classical times were used for the already infected and known to be infectious, not everyone at once. What's being done now has no precedent.
The name quarantine itself comes from a preventative isolation practice.
But lockdowns during pandemics have been practiced occasionally, but always at the city level, due to the nature of governance during past pandemics. Famously Newton and Shakespeare did work during London lockdowns, and some Italian city states distributed fixed rations to peasants to help them stay at home.
What’s new isn’t preventative quarantines, what’s new is global travel and communication.
If that's your comparison, the lockdown has been an outstanding failure because the virus is still spreading widely and pending to go exponential any day the lockdown is slightly relaxed. Heart surgery that can't prevent the heart attack.
Al Jazeera is simply Qatari government propaganda. If they're reporting it and it was 'ignored by the rest of the world', it's certainly only reported for the benefit of the Qatari government.
Donated as I know how hard it is for animal protection efforts to raise money right now (we are a foster home for cats from three protection societies).
I also forwarded it to my network - maybe this helps at least a little bit more in terms of donations.
I'm surprised to learn that animals like dogs (and I presume cats) are allowed on the Galapagos since there is so much at-risk fauna that is unique to those islands.
I was surprised when I first went, the people that live there are allowed on 5 of the islands, with the largest island hosting the town of puerto ayora. The town has 10,000 people, and total population of the Galapagos is 30,000 and growing. It’s an interesting place as people move there from the mainland because of the money you can make in tourism, but immigration is tightly controlled due to the negative effect on nature as the towns expand.
People first started living in the Galapagos a long time ago, in the 1950s they consolidated everyone into the islands they live today. Interesting history for a place that you’d think was purely natural, but human civilization finds a way I suppose.
No. It just isn't following the "whataboutism" logic.
Following this we could say: As there are always young able people in need, why care for old or disabled people who doo not contribute to society and only cost society's money?
Why "donate" taxes for care facilities and such unnecessary stuff?
You're taking this too far. Stop trying to do that.
There is an island on which there are hungry people and hungry dogs. There is a limited pool of donor funds.
The fact that there are people asking for money for the dogs before all the people on that little island have full bellies is just sad.
The dogs will feel no pain from being put to sleep.
Nobody can, will, or wants to even suggest that the children be put to sleep. We will let the children suffer horrible pain before we ever even consider suggesting such a thing.
So every dollar spent on the starving dogs is a dollar that could have prevented some pain for the humans there. It would cost no money and no pain to put the dogs to sleep and ease the pain of some children.
So stop trying to bring the rest of the world into this to win the argument. This is a localised problem on one island, and every dollar spent there should be spent on reducing harm.
You might enjoy reading the utilitarian philosophy work of Peter Singer [1]
A lot of charity donation is based on feelings rather than calculations about saved lives. Otherwise there would only be one charity, and it'd be distributing malaria nets and deworming tablets in Africa.
In my experience, if someone donates $20 to animals in response to lowpro's post, that's not money subtracted from their fixed charity budget that would otherwise have gone to humans. That's money subtracted from their household budget, that otherwise would have been spent on hobbies and bills. People who have fixed charity budgets simply don't donate from them in response to social media posts.
> The dogs will feel no pain from being put to sleep.
> Nobody can, will, or wants to even suggest that the children be put to sleep. We will let the children suffer horrible pain before we ever even consider suggesting such a thing.
Sounds like the proper solution is to convince people that putting kits to sleep is OK, then...
(Not really, but it does seem to follow from your statements)
I may get downvoted for this and I would not advocate this under normal circumstances. But dogs are a source of protein that would be a shame to put to waste given that people are starving otherwise.
By extension of your statement:
Given that there are always people starving somewhere on Earth at all other points in time too, isn't it immoral to feed pets at all? They should be put down and that food should go to people! Dog food in general is immoral, because it could instead be given to someone starving somewhere.
It's a question of scale, and balance. Yes, I think it is ridiculous to ask for donations to keep unwanted dogs alive when there are people on the same island who are suffering.
There are many bad things happening everywhere. That doesn't mean we shouldn't try and stack-rank them, in order to allocate funds effectively. There's diminishing returns to everything[0]. As you throw money at problem #1, it becomes more and more expensive to make a marginal improvement, so eventually, it swaps places with some other problem in the ranking.
There are many criteria you could use for making such ranking of problems (a popular one is minimizing dollars per lives saved, or dollars per QALY added). Living in a free society means people are free to decide how much (if anything all) they want to spend on charitable causes, and on which ones. But in one's individual spending, it's worth to think about how to get maximum "bang for your buck", in terms of alleviating suffering.
Six months ago the shelter didn't need money because people had money and donated it willingly. Now the people around there are starving and can't waste money keeping random strays alive when their own children are starving.
And the people running this shelter, knowing that donor funds are limited, are asking for it to be spent on keeping unwanted dogs alive when there are people starving. It's more humane to put the dogs to sleep. They will feel no pain.
But nobody is going to even begin to consider putting the children to sleep are they? Those kids are going to suffer badly, and you're here arguing that the dogs are more important?
These are unprecedented times, and you can't just waste money.
This is not at all different from what's going on across the US for anyone who works in a service role, and most people still haven't had their UI claims processed / payments made.
> This is not at all different from what's going on across the US for anyone who works in a service role, and most people still haven't had their UI claims processed / payments made.
Exactly. Most of my old team is simply floating on what savings they had, partner's salaries and any money from the family funds we are offered (small grants of $1200 depending on need and availability for FT employees). Some don't qualify for unemployment, as they're just furloughed waiting for a re-open date, or are still dependents and got screwed out of the $1200 checks sent out.
I stepped down from my role as a chef in late January to focus on SpaceX interview(s) and had budgeted accordingly and was ok with passive income sources, but those dried up as the Market tanked, so I had to get really creative this month to make ends-meet because I thought after my interview in February I'd be employed by May. My landlord has made it clear he still expects payment on the 1st, which made me ask serious questions about my current situation.
Ultimately, I have realized I have to go back to tech now as these past years in culinary to get to this point have been incredibly financially precarious, so I took some refresher classes on Coursera and sent out some CVs.
I've heard back from one potential employer so hopefully that pans out as our stay at home requirement is being lifted at the end of this month in CO. My family in CA is still required to stay at home and less than half can work remotely so its putting a strain on things.
This is very true. And OPs point is good: the HN/millennial technorati is really out of touch with how much pain will is and will be descending upon the world.
Source for “most people?” As of April 11, 71% of people who have applied have received benefits: https://www.politico.com/news/2020/04/23/coronavirus-unemplo.... And state’s have geared up processing since then. (Maryland launched new computer system last week.)
It's a class divide, unfortunately. The people who are getting hit hardest are the people who were already getting hit hardest. Most of those don't frequent the same internet forums we do.
This is why "We're in this together" is just not true.
Oprah has it better than me right now. But we both have it way better than my hairdresser (who knows if her salon will survive). And all three of us have it better than a Silicon Valley janitor.
I'm filled every day with deep, deep sadness for everyone whose refrigerators are running out with their bank account at zero.
Not to be pedantic but "Silicon Valley janitor" (at least if it's for a big enough tech co) _might_ be doing OK. Various tech companies have publicly committed to paying their own hourly staff and subcontracted workers like food service / janitorial at full standard pre-shutdown rates: https://techcrunch.com/2020/03/06/big-tech-commits-to-paying...
(Though I have no insight into whether or not they've actually followed through on these public commitments).
This is true. I work for a unicorn and we've committed to paying all of our contract staff until the office reopens. This includes making special payments to the caterer, even though we've cancelled regular lunch and dinner meal service, just to pass through to their employees so that they can shelter in place and not have to be at risk of either getting sick or not being employed.
It also includes all reception and building security staff, even though they are employees of the building management, and not employed by us.
I hope more people know that SV startups, and especially unicorns, are really leading by example in their treatment of the low-wage service workers and contractors that work in their offices.
I talk to the janitor that services our offices at a really high end space near the Moscone. No way dude, those poor people are contracted by a bigger firm, they lost all sources of income over a month ago.
As did non tech companies like Nike. Nike is affording it by not giving a cost-of-living increase this year to the full-time employees. I wonder if there is a list somewhere of all the companies that are continuing to pay their vendor staff.
"We're all in this together" is more of an aspirational phrase, meant to motivate the better-off to contribute. When it doesn't work, the people who aren't better off will of course be reminded every time they hear it that the system is failing them.
It's one more of those meaningless demonstrations of support that social media has generalized.
Communicating that "we're all in this together" is as effective as a giving "like" to the Facebook page of a person dying from cancer raising money for their treatment.
The person who hits that "like" surely feels better about themselves and sees social media as a facilitator of this effortless moral redemption.
PS: The individuals building these systems are aware of this.
Have to say the "We're all in this together" rings hollow for me, even irks me - especially when it's some wealthy celebrity saying it. That said, I feel blessed that (so far) I still have my paycheck working remotely and my wife has her's as a teacher. We decided to keep paying for a number of services (local small gym, house cleaner, gardener) we aren't using - I guess partly motivated by a sense of "we're all in this together" and "it's the right thing to do", etc. But there is a still a lot of risk that I could eventually lose my job depending where all this ends up and with two kids heading to college, a mortgage, retirement coming sooner than later - It's not stress free by any means.
* Essential workers (who make less) required to work and get infected at higher rates, both at work and from their essential worker housemates.
* We permit anyone (even non-essential workers) to hire a nanny, but let no one drop their kid off at a friend's house.
* Deep pocketed businesses like Broadcom can just declare themselves an essential business and mandate employees perfectly capable of working from home come into the office.
> Essential workers (who make less) required to work and get infected at higher rates
Honest question: has anyone published infection rates by occupation? Obviously medical staff reusing face masks in NYC are more likely to contract it, but I'm not as sure about grocery store workers, delivery drivers, pickers at Amazon, etc. Some essential workers in food production (think farmers) are probably pretty low-risk.
Legal enforcement is weak but it is absolutely against the rules (I actually verified this with the health office) and social pressure (neighbors, each other) encourages parents to comply.
Also sector divide. Small business owners are getting killed. PPP and EIDL will be a drop in the bucket. Mass conglomerations are coming and in 12 months we'll wonder why Amazon and Walmart and other multinational corps bought everything up.
You're right. Another issue is the age divide. Younger people: harder hit economically, less so by the virus; older people: harder hit by the virus, less so economically. This can only worsen the class fissure which had already developed along generational lines.
Younger people are less likely to die as quickly from acute respiratory failure from the virus, but if the indications of various delayed and lasting effects are at all accurate, probably are, on average, losing more QALYs to the virus, and so are arguably harder, if less obviously so, hit.
I haven;t seen any non sensationalized evidence regarding long term effects of this virus (health, economically this will permanently cripple many nations). Can you link some health articles?
Sector, yes, but I'd think businesses in similar industries with similar cash on hand for their size would do similarly well, regardless of size. As ancestor said, it's a class divide, but it's by sector and cash-on-hand, not so much by size. E.g. J.C. Penney is big-ish, but struggling because of store closures and cash-on-hand.
Reddit. My state's subreddit has a massive discussion about how the unemployment system is failing, completely unable to handle the enormous number of people trying to file claims. There's a lot of desperation in those threads.
Some politicians have pointed out that some lower income people are getting paid more to _not_ work now, due to unemployment benefits and the CARES Act.
I'm not saying that I agree with those politicians.
It seems like the concern for lower income people runs the gamut from them not being able to make it to them living high on the benefits hog.
Why would you not agree? It’s simple math. In most states, your weekly unemployment is half your salary, up to a cap. Under the CARES Act, you then add $600/week. So if that extra $600 is more than half your weekly paycheck, you earn more on unemployment. It works out to everyone earning less than about $62,000, which is more than half of people in most of the country.
Pointing out that this creates a disincentive to return to work isn’t accusing anyone of “living high in the benefits hog.” It’s not that we’re talking about a ton of money. It’s that we do need most of the country to return to work eventually. And if even white collar workers making $60,000 a year are getting paid more in unemployment, that is a pickle we’re going to have to resolve at some point.
Correct me if I'm wrong, but aren't unemployment benefits temporary? Are these any different? I was reading through the tangled web of information at the DOL[0] and did not come away feeling certain one way or another.
Do you really think not enough people working belongs near the top of our list of concerns at the moment? I have heard this line from every conservative I've talked to about this, and it just seems like missing the forest for the trees. On the long list of systemic problems this period and our response to it is in danger of creating, this seems like it belongs on the list, but not close enough to the top to be worth the time discussing it. I'm a lot more worried about the incentives we're manipulating for businesses and investors than for unemployed people.
Yes, they're temporary. The concern is that if the shut down ends soon (seems unlikely but who knows) then it will delay an economic recovery until the temporary benefits expire. For a faster economic recovery we would want as many people getting back to work as possible. If you make more money not working, the rational choice is to wait for the temporary benefits to expire and then go back to work.
Again, unemployment requires you to actively search for work and accept offered employment or you lose benefits. Higher benefits don't create an incentive to voluntarily stay out of work since you can't have them if you do that.
The requirement to be actively searching for work has actually been temporarily paused in many states, including eg/ CA https://www.edd.ca.gov/unemployment/eligibility.htm. Presumably that provision will be removed along with the SIPs, but just figured it was worth being precise here.
That seems to rely on an assumption that there's no variation in amount or quality of job searching effort, above the minimum required, which might be influenced. It also assumes inability to fake a job search, or sabotage an otherwise legitimate one, which might let an individual so intending to fall below the required minimum. The latter seems questionable, the first seems wrong.
I feel like there's a lot of pedantry in this thread and this topic in general. The point is that people not wanting to work is just so very far from our problem that it is ridiculous to see people harping on it so much. People aren't working because they were furloughed or laid off because aggregate demand is way down, it has nothing to do with the unemployment benefits they're getting. The vast vast majority of those people just want their boss to call them and say "good news! our customers are back! see you tomorrow!".
Of course we are all speculating on what people want or will do in this situation.
But take a hypothetical continuum of unemployment benefits. At which point will your thesis that "people want to work but are unable" switch to "people aren't working because they're being paid way more to not work? The switch will probably be binary at the individual level but will look like a continuum when looking at the population level.
Individuals will of course respond differently depend on the specific contexts of their life. I think in the end a quantity that will matter will be the ratio of unemployment benefits to old job salary. Other factors such as job satisfaction in previous job will contribute to the variance.
I was speaking just to the argument made by dragonwriter that, because something is banned, the possibility has no impact. If you think this was motivated by an ideological objection to government assistance... well, you're mistaken, because I don't have one of those. I can't speak to anything up-thread.
Ok you're right, maybe I have two points: I think this distraction is driven by ideology and partly maintained by (or taking advantage of) pedantry. It is far too tempting for logically-minded pedants to say "but you can clearly see what the numbers show", which is true, but is not a useful point except as further fuel for the distraction.
The real problem we're going to have is people struggling to find jobs as demand ramps back up slowly in fits and starts. This whole conversation is an attempt to portray those struggling people as the problem. It is indirection, like in a magic trick. And the pedantic "well actually"s are falling for the trap.
It's a real bummer because it's definitely going to work, which is going to cause us to underinvest in unemployment insurance over time, which is going to make this even more painful than it was already going to be. It would just be nice if people could see that they're being played.
Calling out significant flaws is not pedantry. Defending arguments because they are "on your side", irrespective of merit, is destructive to the kind of reasoned discussion I value on this site (certainly it's not always available, but let's aim for more of it, yeah?). And I actually think that repeating obviously flawed arguments does the other side's work, turning away the undecided - especially on a site like this.
The CARES Act extends unemployment benefits through the end of 2020 delegates to the states what the job search requirement means. States have a strong incentive to interpret it loosely because the federal government is footing the bill. Additionally, the “offered employment” thing is not hard and fast line. Restrictions will be lifted incrementally—there will be no “everyone back to work moment.” Businesses with furloughed employees will want to call them back up sooner rather than later, but workers earning more on unemployment have an incentive to not come back to work as soon as they could. Businesses, particularly smaller ones, aren’t going to be in a position to say “come back or you’re fired.” (Can you imagine the liability?) It’s during that transition period when the incentives could slow down the recovery.
Businesses are going to have trouble finding enough customers to support the staff they do hire, not this fantasy problem of having trouble finding staff.
That seems incorrect based on a couple of important points. A job is an ongoing relationship that can yield years of income and marketable experience. A fraction of a year of unemployment is not really comparable. Jobs and careers are anything but simple math. Furthermore the recent Pew study indicates that only 29% of unemployed in March collected benefits, largely because systems for distributing benefits are slow and typically service numbers several orders of magnitude smaller. Even in the best of times unemployment insurance has a failure rate of around 15% give or take depending on the state. If a system for distributing benefits is slow, significantly dysfunctional, and prone to cutting people off for a range of reasons then it is unlikely to compete with employment as a source of money, satisfaction, or resume enhancement.
But is anyone seriously advocating keeping a $600/week around after the quarantine? If we can get out the other side without millions of bankruptcies, foreclosures, and evictions, certainly that will contribute to a faster economic recovery. Sure, some white collar workers will be disincentivized from working... as long as the CARES act stays in effect. And you don't get unemployment if you quit, so no one will actively leave their jobs under this scheme.
"The Emergency Money for the People Act, introduced by Reps. Tim Ryan and Ro Khanna, would give $2,000 a month to Americans over the age of 16 who make less than $130,000 a year."
"The payments would continue for at least six months and would last until unemployment falls to pre-coronavirus levels."
That would probably only cost a few trillion dollars. It'll take a decade to get back to pre-virus unemployment levels, and they know that. It took nearly a decade to get to those super low unemployment levels after the great recession, which was not nearly so bad as this situation.
Actually, the payments (because they would encourage marginally employable people to stay out of the labor force and thus out of the divisor for unemployment) would radically accelerate the (brief) return to pre-crisis unemployment. Of course, once they were withdrawn, the unemployment number would shoot back up, but that has no effect on the duration of the payments.
> That would probably only cost a few trillion dollars. It'll take a decade to get back to pre-virus unemployment levels, and they know that. It took nearly a decade to get to those super low unemployment levels after the great recession, which was not nearly so bad as this situation.
Well, it was a horrible way for the US to get to experiment with a wide-scale UBI system and create a viable model. One that was previously thought to be unfathomable, but honestly I'll take it.
And maybe because of my age, but 2008 was way worse than this. This doesn't seem like it will create waves of lost generations, for startes no one is being evicted from their Homes (yet) and no eviction systems are in place in many parts of the US.
> The bill comes as the IRS is about to begin mailing out checks approved by the recent COVID-19 relief package. Those will come printed with President Donald Trump's name on them, it was revealed this week.
Lets see what we learn from this, I'm personally cautiously optimistic on a Human level if this is the step being proposed. I'm just having a hard time internalizing how this is all being done while a clown like Trump is in office... I mean if this Andrew Yang, of course, maybe even Sanders, but Trump?!
In my state, unemployment maxes out at $400/week, not half my salary. So with CARES, I would get an additional $600 for a total of $1k/week. This doesn't last indefinitely, only 26 weeks. Also, unemployment isn't immediate; in my state (prior to the huge backlog) it could take up to 21 days to get paid. Now I assume it's longer.
So someone on unemployment is only "making" up to $26K, then they're SOL.
It’s not a positive consequence. Contrary to popular notions of “bullshit jobs” our economy actually needs all these people to work to maintain our standard of living.
> Pointing out that this creates a disincentive to return to work isn’t accusing anyone of “living high in the benefits hog.”
Sure it is, plus it's a lie since unemployment requires active job search and taking offered employment, except for temporary layoff where you position is retained, where it still requires return to work when the employer ends the temporary layoff. You cannot choose to stay out of work and draw unemployment, so it cannot create incentives to do so.
I think you're being extraordinarily generous in your assumption that people wont just apply to jobs in bad faith. There are myriad opportunities to present yourself as a person that shouldn't be hired that occur between applying and getting an offer.
Im a proponent of UBI, but we don't do ourselves any favors by insisting that the current system isnt exploitable.
Yes, and that's a GOOD thing. If their job really is that essential then it's on the employer to pay them enough to make it worth it. No one should have to risk their lives (and that of their loved ones, and really everyone's) to put food on the table.
Most states are still dreadfully far behind processing unemployment insurance claims. A lot of people who should be getting slightly bigger checks haven’t yet seen a dime of their unemployment insurance.
Yup, my sister said she is making two times as much here in MO. She was blown away. Honestly I thought it was a mistake in her favor until I read this.
Well, there's a very real systems level concern there. There are anecdotes - just anecdotes, but it'll already be a disaster if we start getting data - of workers yelling at business owners for securing the PPP funds to save their jobs.
I have two commercial leases. Neither landlord is offering a break. Construction is stopped due to government mandate. There is no bailout from the state due to this intervention. There is a high liklihood of mass layoffs and potential bankruptcy.
I'm past the point of annoyance or despair. I've gotten used to the fact that not only do governments do whatever they want, but people like authoritarian action and don't care about externalities.
My first tenant's mum was one of the first wave effected in China. He broke his lease to go back and be with her. I then leased to another person, small buisness owner, who was shut down the week she moved in. I let her break her lease.
The best i can do in this situation is get a loan holiday for my mortage from my bank. But i dont get anything for free, i will need to pay it back, plus interest.
The small and medium guys are taking the big hits. The big guys are liquidating to protect investors. And everyone in between is fighting over the scraps.
I believe in karma. When i say we are in this all together, i mean from a civilization perspective, if only 5% of the worlds population has cash at the end of this, that cash wont mean much. Entire nations wont just fade away. Something has to give.
I don't know how the details will actually shake out but the Canadian government this week announced a commercial rent program that seems to make sense. If I understand it correctly basically you pay 25%, your landlord eats 25%, and the remaining 50% is split somehow between federal and provincial funds.
It will be interesting to see how it actually plays out (and now long it lasts) but it seems pretty practical, given the situation.
Can you lay out the chain of events you imagine (or have been told ) will occur for refusing to pay your leases, or at least pay in full? I’m genuinely curious what would happen if you say, “sorry, not paying.” beyond an eviction. It seems like if eviction is the only consequence, it may be worth considering a partial payment as I’d imagine the prospects of replacing you as a tenant are near zero in the short term. (Obviously I’ve never signed a commercial lease so please excuse my lack of knowledge on the terms)
It's scary. I was laid-off this month due to COVID-19. Luckily, I am getting paid for one more month because of the WARN Act. I've been looking, but it has been difficult since I'm competing with all the more senior co-workers and peers who were also laid-off.
So how is my budget?
* I know that there will be a time gap between being able to apply for unemployment and receiving it. The unemployment systems in the US are still overwhelmed.
* Since my wife is on my health insurance plan, COBRA is going to be very expensive.
* We moved recently for my job, so a lot of the savings we had are already gone.
We have some runway, but no where near enough to feel safe. We are one of those edge cases where we took a risk, it paid off and life was great, but it didn't last long enough for us save up again so things are looking grim. So finally...
> Yet when I read Redditors talk about quarantine, you'd think everyone in the world was getting paid time off to play Animal Crossing at home or they live at mom's house rent-free. And it seems like it's this crowd that's likely to be pushing for staying in lockdown with no end in sight.
We both still are 100% for maintaining the quarantine. No we are not living some relaxing lifestyle at home. I've been quite stressed out. However, I also know that I would never forgive myself if I contributed to breaking quarantine early and that caused a chain reaction of hospitals to be overrun again and leading to my parents, a relative, or an old friend to die because they could not get the proper treatment.
There is a lot I want to rant about, but rather than that, I would like to leave these thoughts:
Stop thinking of the solution as being so black and white. Lifting the quarantine isn't the only way to help everyone who has been impacted. For example, why not have the same government bodies that enacted the quarantine do something just as drastic to save those who were impacted? What other solutions are out there?
Also, if lifting the quarantine leads to more deaths, then remember that there is an economic impact there too. Have you ever paid for a funeral? I have and at a young age too. It burned a hole in my savings. That set me back several years in saving and investing in myself. Imagine doing the same to the generation of young adults whose parents are in the risk factor group. Far too many of the comments I read, even on HN, are seeing things only through the lens of what politicians say. Outside of compiling raw statistics, I've seen very little independent thought on how to solve the current problems in society.
If your wife is working and has health insurance, you probably both qualify for special enrollment onto hers. And as a neighbor said, Covered California (ie CA's Obamacare) will enroll you. The other thing that may help is you have 60 days to enroll into cobra. You can wait until eg day 55 before seeing if you used it, as long as you have the cash to float if something happens and you end up needing to enroll.
FWIW, SF Fire CU in the bay area has credit cards that charge 7.5% rather than the 25%-ish at Capital One or Citi.
If you enroll in COBRA within 60 days, you can retroactively claim coverage. If you have current cashflow issues but have only minor healthcare expenses, you can wait to see if you need it.
Of course before going this route, check with a reputable source.
Note: This was back when I lived in NY and I know this differs by state, so this is not all around advice.
I’ve been on COBRA twice before using the 60 day “trick” due to recession related lay-offs. Luckily, the previous times I didn’t have cash flow issues, but I did learn that to get reimbursed once you opt-in and pay those back months can take many, many weeks. So while it may seem like you possibly extending your cash flow, you are actually playing a risky game of chance. Cash flow will end up being far worse off if you get unlucky.
I know I’ve replied more than once in this thread shooting down suggestions, but do know that I appreciate the advice. I’ve just lived life having quite a few unlucky events at bad times, so I’ve learned to always consider how worse off things can be for others.
What I was hoping for with my post was to solicit actual introspection and suggestions for alternative fixes that the HN community could iterate on. So please, I hope people will focus on that instead of my situation. Thank you.
My wife is a certified social worker and knows just about everything there is about that. It’ll be cheaper but far worse in terms of coverage and deductibles. So it’s an option for stretching budget, but it’s not a good solution if anything significant happens. I’ll ask her if she knows what’s changed with regards to COVID-19 related cases, but my guess is that nothing in terms of coverage has changed. So given the current world circumstances, switching would be akin to taking a giant gamble on your health.
Unless you have pre-existing conditions or very expensive and rare prescriptions, it's probably worth the gamble to go to something like a silver plan at this point. How many months of COBRA would you pay until you reach the max out of pocket payout for the silver plan is some math you should do. You can scale that based on your risk tolerance.
Is medicaid a good option? I think you should qualify in California. Also, I don't know your situation, but has your health needs changed recently? I know Kaiser is trying to limit unnecessary office visits.
In California, Obamacare IS Medical (aka Medicaid). I signed up once. I couldn't get my Vyvanse for my ADHD because it's a controlled substance, and the Medical doctor wouldn't touch a prescription for it.
Pro-tip:. If you pay out of pocket for your regular doctor (maybe tell then your situation and work out a deal), you can get Medical to pay for the prescription (verify before trying).
There is a grace period before you have to start paying, and the dates should be on the letter you receive when you leave your employer. The grace period does not last forever, and when it's almost up, you need to pay several months at once to get coverage. (another comment suggests these rules might vary somewhat by state, and I'm sure that is also possible)
For ACA, policies, the grace period is forever. Job loss is a "life event" that lets you jump in any time, not just an arbitrary open enrollment window.
The grace period to start paying for a plan under the ACA is 60 days, not "forever." It's true that you don't need to wait for open enrollment, a special enrollment period opens for you when you lose your job.
edit: I'm not sure there's any grace period at all with the ACA. You have 60 days to sign up, but unlike COBRA, I don't see any evidence you can start using the insurance without paying for it first, which is the nice thing about the COBRA grace period.
I don't see any evidence you can start using the insurance without paying for it first,
Because there's no limitation on pre existing conditions, it's effectively the same. You can sign up the day you get sick and have a free ride until then. That's why the CBO scoring was all bullshit.
> Because there's no limitation on pre existing conditions, it's effectively the same. You can sign up the day you get sick and have a free ride until then.
How does that work if you've suffered a catastrophic injury and you're not well enough to sign up until after you've been treated in the hospital for several days?
It's similar, but it doesn't sound like the COBRA thing, where you have the option to retroactively extend your employer's coverage, or not, for a couple of months and you can still visit the hospital the same as you always did (or not) because of the payment and notification grace period. If it turns out you didn't need the insurance, you don't need to pay for it.
Hum. In IL and IN you have either 45 or 60 days to accept or decline coverage (don’t quote me on exact number, do the research). It made the optimal short term insurance policy to be:
Don’t fill out cobra paperwork to day 59
If not sick or total bills less than 2 months cobra payments, decline cobra.
If sick and total bills > 2 months cobra payments, decide to accept coverage.
Used this for like 5 job hops. Never had to opt in, but it seemed fine. Confirmed with HR several times that it would work as I said.
After 2 months it starts to get gross. Likely want to get an emergency only plan.
I think your heuristics change if you happen to have an ongoing condition or family needing coverage (who may also happen to have costly out-of-coverage costs).
This is the kind of mental gymnastics that would be completely avoided if we had even the most basic of universal coverage.
It's the same in CA in my experience. I guess people don't think about it b/c we're used to pre-paying for insurance and with COBRA there's a decent period of time to make a decision and you also pay for insurance the following month instead of paying for it prior to/during the month.
Thank you for putting into words precisely how I'm feeling about this situation. The goal was to flatten the curve, not protect every single person from getting exposed which is impossible and seems to be what those who are not suffering economic hardship from this (yet) are now asking for.
There does seem to be a fundamental misunderstanding about how we are tackling this pandemic. We are not trying to prevent infection because we don't want any new infections. We are only trying to keep the rate of new infections low enough as to not overwhelm healthcare capacity. More people getting infected everyday is part of the plan.
In many parts of the US it is time to start cautiously reopening more parts of the economy, exactly as is occurring now in a dozen European countries. The main impediment to that is our testing rate, which still lags other Western nations that are easing lockdowns.
In the US, the third category is being furloughed and collecting unemployment. Here in Maryland, anyone making $55,000 or below collects as much in unemployment (with the $600/week federal supplement) than they did while employed. The IT systems have done a bad job handling some new categories of claimants (people who couldn’t collect unemployment before but were allowed to under the CARES Act). So some people are waiting for checks. But others are relatively unaffected: when the stay at home orders end, they expect to get called back to their jobs.
Just a mathematical nit; Maryland caps unemployment at $430 per week. So adding CARES bumps that to $1030/week. It's only lasts 26 weeks, so it's worth $26780. I'm not sure if you have to pay income tax on any of this.
It’s the equivalent of a $53,500 annualized salary in terms of weekly paychecks. Also, CARES Act extends unemployment through the end of the year (39 weeks). A recent U of Wash study projected states could start easing restrictions in late May to early June. But it’s going to be a slow reopening. The concern is that if the federal government is bankrolling things, the reopening will be slower than necessary.
First of all, you pay income taxes on unemployment income. The additional $600 per week as part of the CARES act is only through July 31st. Then it reverts to just the ase amount - which is whatever percentage of your income (until it reaches a capped amount) that unemployment insurance pays out, which varies by state.
I was laid off last year from a non-tech job and at the time, had savings and unemployment to not worry about paying $1800 for rent plus reduced additional expenses for a respectable while (without losing everything) but it's a very different story now.
Since COVID, my landlord said he could let me defer payments for a few months, but honestly that’s not helpful at all since I’ll have to pay in full eventually.
I previously felt relatively comfortable with my opportunities to find new employment in marketing or a career switch to product management. But now, cash is low and what few jobs are available are flooded with applications and high competition from all the layoffs. I can't even get a food delivery gig because they have so many applications.
It could be worse, but my wallet and savings are taking a serious beating and probably will for quite a while.
So if anyone has ANY marketing or PM needs or questions......... Say hi, email in bio! Happy to connect at the very least.
I feel a strong division of producer/corporate vs consumer in Reddit today. Every sub is more or less a “fan community” defined by something external, something its userbase only communicate with over the counter, and that doesn’t happen elsewhere.
> Yet when I read Redditors talk about quarantine, you'd think everyone in the world was getting paid time off to play Animal Crossing at home or they live at mom's house rent-free
Wouldn't this be a self-selecting population? or is everyone whether rich or poor, good circumstances or bad online?
Yea I am wondering the same thing. I am REALLY lucky to have saved a lot and be in a good living situation where I can quarantine comfortably. But what the hell are people doing who were paycheck to paycheck? I would not blame them if they had to start stealing from supermarkets
In the old days people were part of families which were part of communities and they would all take care of each other if something like this happened. We've obviously gone far far away from that. I wonder if we will start moving back toward that sort of society?
As Margaret Thatcher said - there is no such thing as society, there are only individual people.
Seems like over last 50 years many people had been brainwashed to believe it is so.
But people are not the largest, quickest or most dangareous species on the planet. Our strongest point had been communicating and working together toward common goals, creating the society and taking care of each other.
Saddly in last 50 years this darwinistic vision of getting ahead at all cost at the expense of the others prevailed.
There are lots of food pantries in the US and in many of the cities the schools are using the school lunch program money to package food that parents can pick up from the school. There are many avenues for honest people before they have to resort to stealing from a grocery store.
It’s naive to think this works for everyone. Independent contractors are getting screwed. Small businesses are getting screwed. Sure, there are some solutions on paper, but for a lot of people they have not come to fruition yet.
Edit: People downvoting me are proving my point about being naive. I’m giving my input as someone who is in a much different position than most of the privileged commenters here. Feel free to ignore it, it just grows my disdain for the stereotypical tech worker, a well-paid sheep that’s never faced any kind of hardship yet thinks he knows what’s best for people who have.
Not everyone fits into a perfect little box of “job” or “no job.” I personally am an independent contractor who’s been burning through (minimal) savings while building a startup that doesn’t exist yet. I’m eligible for the $1200 check, but I have no idea where it is and the IRS website is a blackhole. I haven’t tried for the PPP loan yet but it’s not helpful.
Independent contractor, self employed, and gig workers can get unemployment now because of the stimulus bill even though they aren't normally be eligible. If you are making substantially less than before you can get partial unemployment, and it could make sense to quit working and quarantine given the benefits and your economic prospects. I agree that this won't work for everyone though. The bay area specifically has more people with jumbo loans, and these are not federally backed and part of the forbearance program. The cost of living in the bay area is higher, so this stimulus will not go as far as many places. The cost of healthcare is still a concern if you get sick, even with insurance.
The amount of unemployment benefit scales with income, and $450/wk (plus $600 from the stimulus) is the maximum, to be clear. A full time worker paid $15/hour would receive $300+1000 per week.
Your math is a bit off. $15/hour fulltime is $7650 gross per quarter. According to the EDD PDF you linked, that would qualify for $295/week in unemployment plus $600 from the Feds for a total of $895. No one is going to get more than $1050 combined in California.
Luck might play a role in whether you got a good job, but saving money is mostly a product of willpower.
I would not blame them if they had to start stealing from supermarkets
Would you blame them if they stole $15/pound steak instead of $0.20/pound bags of flour? Because few people steal bags of flour--that is, few people steal food for purposes of preventing starvation. It's mostly driven by the same impulse as any other form of stealing.
People dont do bad things because they want to be bad or lazy. Thats Nixon era properganda used marginalise the anti-war hippies in favour of the Military Industrial Complex.
Conversatives will trumpet this till the cows come home while simultatiously gouging the govenrment with there large businiess for subsidies, discounts, monopolistic laws, on everything they do.
You could pay entire swaths of your population unemployment, or you could subsidies the creation of a new oil processing facility and let that company then employ the population. When you subsidise big buisness, that money goes straight into family trusts. When you subsidise people directly, that money goes straight back into the community.
As soon as u pay people a basic income, they have the chance todo what they want in life. People dont want to steal. They only start doing that once they are disenfrancised and already marginalised.
We keep in touch with our old nanny from a couple years back who became close with our family — just spoke to her and while they’re doing alright for now, it’s an uncertain and scary time for them. Same for friends and family in service and manufacturing. Some have lost jobs and are in limbo. Older relatives are relying on a network of friends to figure out groceries in areas without delivery.
We’ve continued paying our housekeepers and Montessori throughout all of this; it sounds like most of our community has been doing the same, based on emails from management, and chatter on Nextdoor. But this will vary widely depending on the particular community. Just like when a storm hits, the communities which are already less fortunate will typically get hit the hardest.
And then of course, the local businesses. When the tide recedes, I really don’t know how many of our favorite shops and cafes will still be there. Those folks are sitting on edge right now.
The social media feeds are going to be self-selecting for bored, single, young people. Anyone taking care of young kids at home are too busy looking like Arnold Schwarzenegger in “Kindergarten Cop” to be posting very much right now.
There's another political solution that would maintain the lockdown while preventing thousands of people from dying by reopening the economy: cancel rent. In NJ, they canceled mortgages but not rent, so the landlords get a free ride. In theory rents are "frozen" but they'll become due in September with back rent owed.
>Will I have to make up the mortgage payments at the end of the 90-day grace period?
>Yes, these mortgage payments will need to be made up by consumers. The Department has requested that forbearance payments be added to and made at the end of the life of the loan. However, consumers should contact the institution that services their home loan to understand the specific programs and terms available to them.
I don't know the NJ specifics, but if they are like anywhere else on the world, mortgages weren't cancelled, just the time not paid added to the end of the term. Sure if you have 20 years left, 20 years + 4 months isn't a big change, but you still have to pay the amount owned. For landlords is the same, except it is in a shorter time period (but then again, not a lot of people rent the same place for 20+ years)
The munis and banks all have a direct IV funding line from the Federal Reserve, they mostly have absolutely nothing to worry about. The gloves are entirely off for this one, the Fed can snap up trillions of dollars in toxic mortgages if needed, they've got the greenlight across the board for any and all actions.
The Fed keeps lowering the thresholds (and they'll end up doing a lot more than that in the coming months; most of this won't be short-term credit, they'll switch it to long-term out of necessity):
"Fed expands muni-debt program to cover smaller cities, counties"
"The Federal Reserve expanded the scope and duration of the Municipal Liquidity Facility, a $500 billion emergency lending program aimed at providing short-term credit to state and local governments as they endure the economic fallout from the coronavirus pandemic. The U.S. central bank lowered the population thresholds under which counties and cities would be eligible to sell short-term debt to the facility. The new levels are at least 500,000 for counties and 250,000 for cities, down from 2 million and 1 million."
I work for a fortune 500 financial institution. After what happened during the last crash we had a policy of 365 days of liquidity. So far this time we haven't used the Fed firehose of $, but according to our CEO the Fed has asked us to start using it. I don't understand why the Fed would ask us to use something we don't need.
Depends on the REIT. Some do malls, some do apartments, some do hospitals. I'd expect a residential REIT to see a one to two quarter drop in dividends by maybe 25%. I'm having a hard time justifying a longer term dividend drop or valuation drop because there's still a housing shortage in the US. Unless more people move in with their parents, or something...
>> I'm having a hard time justifying a longer term dividend drop or valuation drop because there's still a housing shortage in the US
Real estate is all about location.
Major cities have a housing shortage and will continue to be able to find some tenants. Rent is likely to go down or stabilize for some time.
Small town will be decimated. All the jobs that are disappearing are not coming back, people will have no money for rent and there are no other tenants immigrating in.
I'm pretty worried about my family. My dad barely survived 2008.
My extended family is heavily dependent on commercial real estate. My dad is the least (relatively) successful/smallest of the family. He's an agent (and small owner). At the end of 2019 helped facilitate a HUGE __ insert a top firm __ reit deal; $10 digits in a small ish state. Literally the top of the market. There's a reason his friend who sold that insane Sq Ft was already super wealthy. The small buildings my dad owns sounds like many can't pay rent.
I personally hedged a bit and including put REIT exposure. But despite having a super pessimistic view on the economy, seeing losses now is scary and I'm thinking about closing (i did move my main savings into much safer territory before the biggest drop and govt said they will buy unlimited bonds/debt..). That idiom the market can remain irrational longer comes to mind
It depends on your risk tolerance. If you're hedged with a long put on a decent time horizon, I don't think you have much to worry about, as you're locking in a price in case the REIT falls significantly. Your max loss is capped at the premium+commission you paid for the long put. It helps to have some physical precious metals, as paper precious metals are risky and I don't think COMEX can enforce their futures contracts effectively. This is to hedge against currency risk.
I am in Germany and am lucky working remote for my local company.
I talked to my neighbor on Sunday. She is a cleaner working for a subcontractor cleaning schools. She wasn't able to work for 9 weeks (first there were holidays, then Corona stay at home rules). She isn't being paid and her boss does not go through the official process of getting government subsidiaries for her. She is just being left hanging.
Yeah her boss is an ale. It would cost a little bit of time and get all his employees 60% of their net income. He just isn't doing it.
Her sons earn okayish - so they help her out. And we do neighborly community help. Non the less. People left and right are being left behind. Even with government interventions in place.
Alameda county flat out does not allow evictions for non payment of rent for covid-19 related reasons. The landlords can get back rent on a 12 month payment plan, and they can pursue small claims court if this is not paid.
But commercial evictions are still done judicially in CA unlike some other places, and at least in Alameda county the ability of the business to repay is factored in
I know that for my oklahoma college friends they often had rent around 250/month for a room in the oklahoma city metro area (norman specifically). 200/month in some small oklahoma town is probably doable for a room.
It's been a decade, but a friend in a college town just north of Dallas had an off campus apt for $300 a month. I had an off campus apt much closer to everything for under $500, similarly a friend even closer had an apt for $500.
The prices are a lot cheaper in a lot of US metros than the tech centers.
The problem is that the shelter-in-place rule is already limited in effectiveness due to a very lengthy list of exceptions plus many people not observing the spirit of the rule. Compliance will only drop over time as people see that 1) Their actions are having no obvious impact and 2) There is no clear end in sight.
If the primary goal of extending the order is to give local governments time to build out infrastructure, that's fine (though they would do well to communicate this progress to the public). But if the primary goal is to further reduce transmission, I can't see it being successful.
What evidence is there that the SIP is limited in effectiveness? The existing evidence I am aware of is starkly contra that assertion. Anecdotes of seeing people too close together in the park are not evidence of an ineffective SIP.
It's not that SIP does nothing - it's that past a certain point, the rates are what they are. San Mateo and Santa Clara counties have seen a slight increase in the number of cases last week over the previous week. Other Bay Area counties have seen a slight decrease [1].
I don't see how increased traffic/travel as we're starting to see [2] will do anything other than increase transmissions.
But if the rates stay the same, then all we're accomplishing is slowing the rate at which we reach herd immunity. If herd immunity is the strategy we're pursuing, then we should lift restrictions enough to meet hospital capacity, so we can get to herd immunity as quickly as possible and get the economy back to something approaching normal levels of activity.
If the strategy is actually suppression and elimination, then the lockdowns are not working (at least not here in Oregon, where daily number of new cases have been flat for about 2 weeks; I'm not sure what things look like in California).
> If herd immunity is the strategy we're pursuing, then we should lift restrictions enough to meet hospital capacity, so we can get to herd immunity as quickly as possible and get the economy back to something approaching normal levels of activity
If it were remotely possible to precisely control the transmission rate such that we stay just under hospital capacity, there would at least be a coherent argument for this. I'd disagree, since a huge part of slowing the spread is to buy time for other mitigation options, such as therapeutics, contact tracing, etc. That said, it has been immensely frustrating that CA and SFBA leadership hasn't provided more clear guidance on what, exactly, we're waiting for.
> But if the rates stay the same, then all we're accomplishing is slowing the rate at which we reach herd immunity.
No, we're still avoiding surging past healthcare capacity, which shoots the fatality rate for both the disease itself and anything else that competes for resources with it way up. That's the point.
It's true that on some places we may not need SIP to remain in the safe zone, but one of the big problems is that we don't have the kind of surveillance that lets us even be clear what the likely course is, because we're still mostly testing only the very sick because of limited testing availability and infrastructure, which means we have no good future window, and we won't be able to restore SIP in time to prevent a surge because by the time we see it in the case numbers the infections that will take us beyond capacity will already have happened.
That's one of the reasons establishing better surveillance is one of the keys to reopening identified by (among others) the West Coast group of states coordinating on the issue.
That's the trouble - there's evidence the main reason that the fatality rate shot up massively in places like Lombardy and Wuhan with overwhelmed healthcare systems is because the shortage of healthcare resources meant they massively undertested mild cases compared to elsewhere. It's a statistical artifact that was presented as a real thing by the useless media. Also, people aren't getting healthcare right now because of the lockdown and the fear. All over the Western world, cancer screening and treatment is getting skipped, people with strokes and heart attacks are seeking medical care far too late, kids are missing vaccinations...
> That's the trouble - there's evidence the main reason that the fatality rate shot up massively in places like Lombardy and Wuhan with overwhelmed healthcare systems is because the shortage of healthcare resources meant they massively undertested mild cases compared to elsewhere.
No,the death rate among those requiring ICU care shot up, too; and there is no question that the reason is that the systems were so overwhelmed that things like ventilators were rationed on criteria beyond medical need, because medical need exceeded supply. (That's also why other conditions became more dangerous, because it didn't matter why you needed, e.g., a ventilator, whether Covid or not, the supply shortage meant you might not get one.)
The strategy is slowing the spread. Elimination was impossible the day the virus left wuhan. We can't lift restrictions to meet hospital capacity because that is an extremely dangerous gamble, especially when all our numbers on the spread of this disease are bound to be underestimates.
The goal is to not overwhelm the medical system. We are achieving that goal currently by not overwhelming the medical system. The strategy is working right now, no reason to balk from it if it's getting desired results as this pandemic runs its course.
I'm a little confused about your semantics, so I fell down the hole. A strategy is the plan of action itself to achieve a goal, and the tactic is the action or strategy to achieve the goal. Slowing the spread seems to fit both definitions depending on how you word your sentences.
With a two-week asymptomatic incubation period, there is basically no way to eliminate the disease just by sheltering. It's impossible to enforce that every person in the world self-isolates for 3 weeks, so as soon as we "return to normal" it will come back.
The strategy is basically, in order:
1. Reduce the rate of transmission to avoid overwhelming hospitals (which would increase the fatality of all other illnesses/injuries). When we have no reliable testing infrastructure, the only action we can take is sheltering-in-place as much as possible
2. This buys time to increase medical supply chain capacity and stockpile necessary supplies. This increases the amount of cases the system can handle, which is important when the public policy feedback loop doesn't see new cases until they're in the hospital weeks later
3. At the same time, build testing infrastructure to detect infections before they turn into uncontrollable outbreaks. This will hopefully catch cases before they get to the hospital, shortening the public policy feedback loop
4. At this point, we should be able to resume some moderate amount of activity without being completely in the dark. We will likely see a cycle of one week on, one week off, two on, two off, etc as we see how much we can control the rate of spread. This will increase herd immunity, but
will likely require months to spread the infection without overwhelming our health system
5. All throughout this time, high risk populations will have to isolate as much as possible, since they cannot be infected safely. Medical companies will be working on a vaccine, but it will probably take closer to a year before they are ready for the market.
There's also the goal of slowing down and stalling in hopes of getting a vaccine, better treatments, production to catch up with supply shortages for healthcare facilities, and allowing healthcare facilities to increase capacity, etc.
Has there been any research on survival rates over time? If given the choice of getting COVID-19 today or two months from now I would much prefer the later infection because that’s two more months of doctors learning how best to treat the disease. Even delaying infection by a week seems like it would offer a better fighting chance. The medical community is learning as much as they can as quickly as they can and that benefits everyone who will eventually get sick.
It’s complicated a bit because of limited hospital capacity and related treatment supplies. If where ever you are is still below saturation later is better than now probably but once your local system is in the band where they’re running out of supplies things can get pretty dire.
Barring a miracle, mass production of a vaccine is at least 9 months away. Likely more like a year+
There's no better treatments coming. We've been fighting viral pneumonia since the dawn of medicine and the tool kit is pretty sparse. Finding anything nearing a cure or even a 20% improvement is wishful thinking.
Our health care capacity is adequate. NYC got to ~30% infected and while I'm sure none of the medical workers want to repeat the experience the level of care remained good. Any capacity increase is going to come with only marginally improved outcomes.
There's no purpose in extending the lockdown. Either we can get back to something resembling normal life and control the spread or we can't and everyone gets infected. Extending the lockdown is just delaying that day of reckoning.
The comment you are replying to should have also mentioned greatly increased testing capacity as well as contact-tracing. Extending the lockdown allows us to build up this infrastructure so that restrictions can be reduced while still preventing exponential spread.
We can't control the spread until we can test people for the disease. As multiple leaders have stated, the lockdowns need to continue until we build up testing capabilities. For instance in WA, the governor said they are waiting for "widely-available testing, quick isolation for those who may have the virus, identifying people who came into contact with a positive case and getting them into quarantine."
The only country where this seems to have even vaguely worked is South Korea, and the US is already testing much more people for coronavirus than South Korea even in per-capita terms. Has been for a while. Now, the New York Times editorial board has been pushing the idea that you're behind South Korea because more of your tests are coming back positive - but the way they dropped that number is by using stricter social distancing measures to drop transmission rates, not increasing the number of tests. That doesn't seem to be happening in the US even with a full lockdown, and we don't really know why.
Basically, all of the US media reporting around testing has been terrible, misleading, partisan nonsense designed to create an imaginary testing gap that can be blamed on the current president to try and kick him out of office in November. Publications like the Times are quite open about why they're doing it. The UK isn't much better though.
I don't care what the comparison to South Korea is, and I don't expect other countries to have already achieved this. I care whether testing is widely available enough that a person who finds out that they had dinner with someone last night who has coronavirus can go and get tested immediately, not wait until they are short of breath and feverish.
If you are dismissing "all of the US media reporting around testing" as terrible, misleading, partisan nonsense, then you are either looking for a particular opinion to be represented that isn't, or, more likely, you aren't reading all of it.
If no country has ever achieved this, what's even the evidence that it's actually possible? There are some pretty fundamental reasons to think it wouldn't work, not least of which are asymptomatic, pre-symptomatic and barely symptomatic spread, and the fairly impressive R0 of this particular disease. If the person you're having dinner with doesn't have symptoms and you have a slight sniffle, how do you even know to get tested?
Also, how the amount of coronavirus testing the US is doing stacks up to other countries isn't an "particular opinion" - it's a fact, and it's a fact that pretty much the entire US press seems to have managed to misinform everyone about, including the fact check columns.
Thats what contact tracing is. Your dinner companion finds out they are sick two days later, and everyone they were in contact with gets found and tested.
The amount of testing the US is doing is indeed a fact, and it's widely reported in US press.
People keep saying that, but I haven't heard of any clear examples of actual sick people who got it again, just positive tests that seem to be within the error bands for the tests.
Not a doctor, this is not a rhetorical question: Shouldn't we have those 2nd-time sick people by now? Shouldn't the null hypothesis be that immunity works like most other colds?
Masks weren't "proven to be effective" until well after any reasonably thoughtful person was wishing they had one.
- of 4 coronavirus strains in one study (all the type that cause common colds), none gave long term immunity after exposure
- of those 4 strains, getting re-infected multiple times in the same year is common
- each person tends to have a consistent reaction (weak/strong symptoms the first time through predict a similar experience in any later infections)
- infection severity tends to run in families
- 6 years after SARS, doctors found T-cells, but no B-cells in humans . Mice re-infected with SARS were protected from the worst effects or SARS by memory T-cells.
Specifically related to covid-19:
- macaque monkeys were infected by covid-19 and exposed again 4 weeks after recovery. none developed symptoms or had detectable virus in their throats
- no reported cases of re-infection in Wuhan in the 5 months since the epidemic started
> Shouldn't we have those 2nd-time sick people by now?
Maybe if there was no infection induced resistance, but with even moderate resistance lasting a few weeks, probably not outside of Wuhan, and it's not like we can be confident we'd get accurate information on that.
> Shouldn't the null hypothesis be that immunity works like most other colds?
Colds are mostly rhinoviruses, this is a coronavirus, so, no, you wouldn't by default generalize from colds. Coronaviruses don't particularly consistently produce long-term reliable immunity, instead what immunity they do produce typically wanes quickly. So the best assumption would be that whatever resistance getting infected confers is likely quite limited in duration.
Herd immunity? Is it proven that immunity lasts long enough to provide coverage to the herd?
The issue I have is that if we overload our medical system - just go on twitter to see the horror stories posted about ICUs and medical staff in serious depression - then even if you have a totally managable non-COVID acute issue, you could get infected or die by lack of treatment because the system is at or beyond capacity.
We are in a fight to keep our current medical system running. If you overload it recovery for that may take longer than the hypothetical herd immunity or vaccine.
For curves: Flat = working. exponential = not working.
I'm confused how the SF chronicle is calculating numbers. Santa Clara added 183 cases in last 7 days vs. 256 in the previous week (quite a downturn in the face of increasing test capacity).
They might have gotten hit by a glitch where Santa Clara didn't report for 3 days.
That was/is the precise reason given, so it's hard to imagine this going on much longer given that hospitals are doing fine. I think another month is going to lead to chaos and many people rebelling.
Ah yes, the argument that protective measures are succeeding and therefore they are no longer necessary. Completely irrational in a scenario where the danger being protected against hadn't gone away.
Instead of gallantly assaulting a straw man, you could acknowledge that lockdowns are not an on/off proposition and that there is almost certainly a better implementation of precautionary restrictions for achieving our goals than what we currently have.
Calling it a straw man implies that you don't think anyone is actually making this argument, and that's simply not true.
If you feel compelled to defend your own position instead of the one I'm criticizing, go ahead, but I don't share your certainty of there being better possible implementations.
Where did I "argue" that protective measures are succeeding therefore X? I'm merely stating that you cannot have a society of 350M people completely stop what they're doing for 6 months and not have disastrous consequences. At some point we have to choose whether the lives we're potentially saving after lockdown month X vs the emergent problems from shut down are worth it.
gotcha. I think it's disingenuous to effectively say that people are too stupid to make their own decisions regarding personal safety. There're growing calls to ease the lockdowns right now from people with top scientific credentials. I personally know doctors working in large hospitals who have said it's time to ease restrictions in most areas. It doesn't have to be all-or nothing.
If this were about personal safety, it'd be an entirely different scenario. The problem is that people's actions here are significantly affecting the safety of other people.
A virtually identical argument could be made for the same thing with the sides swapped. Some people's actions (i.e., those imposing lockdowns and other restrictions) are significantly affecting the safety (i.e., mental health, solvency, etc) of other people. It's a balancing scale, not just an independent bar you're trying to drop to zero.
Sure. And that's why there is a complex list of things that are being banned or not, that varies by location, instead of simply telling everyone to go inside their house and not come out for three weeks. And significant legal changes, like unemployment eligibility, loan programs, etc. Exactly who are you thinking of, that is advocating to continue lockdowns because they aren't aware of all the tradeoffs involved?
I can't prove he's unaware, but I have yet to hear a single mention of any tradeoffs like these from Washington's governor. Every single rationale he has provided for his actions has solely been based on covid-19 infected and deaths numbers.
So the WA governor (which is where I live) is the one who declared expanded unemployment access, defined and modified the list of essential businesses and is constantly talking about what is preventing us from opening up the economy - and yes, that's the deaths you mentioned. And you aren't sure if he knows about the disadvantages of everything being closed, because he hasn't included any details on why he wants to work towards reopening everything? I don't even know where to start. I think that the idea that is unaware of these factors is simply ludicrous.
I made a map where you can move day by day to see the progression. The lockdown has minimal effects, cases have been increasing steadily for a while in every country, seemingly as quick as there are tests.
Perhaps badly worded on my part. Limited != none. Clearly SIP has bent the curve. But new cases that are being reported now were transmitted well after SIP came into effect, i.e. are happening despite SIP. And absent other policy changes, we should continue to expect to see more of them. What changes we do see are in the other direction - more traffic, more outside activity, etc.
Practically, increase (or non-decrease) in weekly number of cases in San Mateo and Santa Clara counties suggests as much[1].
Cause they wouldn't open everything up at once and people have shifted their behavior for the foreseeable future. I imagine a series of flattened curves one after another through the end of the year will be what happens as they open up pieces of the economy, presumably with better testing and tracing to control outbreaks (still to be seen).
Bay area new case count is pretty much flat at this point, and I don't see why it would be that much lower in June, the thing is bubbling under the surface and won't go away until a vaccine.
I'm not sure people's behavior will stay changed, but that aside - that presumed "better testing and tracing" is exactly what we are waiting for before opening up. It doesn't exist yet. Reducing restrictions while we still have up to a two week lag on tracking infections means that we won't know if it's going OK.
Things will always be better in terms of testing / tracing / treatment options in a month, in June if we just wait until July things would be in a better place. Ultimately this is going to be about buying time for as long as is politically and economically possible. If more and more states open up and their situation doesn't look like a disaster because they are not as dense as NYC with almost 4 million people taking subways every day, then it's going to be harder and harder for the bay area politicians to claim we need to stay shut down.
You're arguing as though "better testing/tracing" is an amorphous goal that keeps moving, when people are actually talking about quite specific and quantifiable goals. For instance, in WA:
"The recovery plan begins with widely available testing for individuals who may have contracted COVID-19, tracing for those who have come into close contact with COVID-19 positive individuals, and isolation or quarantine for individuals who could transmit the virus..... For the contact-tracing plan to work, the state needs to be processing between 20,000 and 30,000 tests a day."
https://medium.com/@WAStateGov/inslee-announces-washingtons-...
Fair enough, I wasn't aware the exact number of tests per day was quantified. Let's see if they stick to that goal and achieve it, or revise requirements next month if they learn the R0 isn't as large as thought in certain regions or we have beneficial climate effects, etc.
The stated goal is to decay to 1 infection per million residents so that robust contact tracing works. Back of the envelope math puts that between 6 and 18 months of continued progress of the health order to get it to this level.
(60 or so in Santa Clara County ICU == ~6000 infections. ICU occupancy decaying by 40% per month; 0.6^15 months * 6000 = ~3 )
so you think 6-18 months of SIP is going to work? I think that could lead us to a dire situation.
> robust contact tracing works
Doesn't that rely on the individual opting in/using it? I have a feeling most people don't want the government tracing their every move (even though it already is geographically).
> so you think 6-18 months of SIP is going to work? I think that could lead us to a dire situation.
No, I don't. I think it's implausible. But this is what those in local public health are calling for. Granted, there's the IMHE model, which somehow fantastically thinks the virus will mostly be gone in Santa Clara County in mid-May, but it's shown very little agreement with the actual data and is nearly as bad as saying the Easter Bunny will take the virus away.
> Doesn't that rely on the individual opting in/using it? I have a feeling most people don't want the government tracing their every move (even though it already is geographically).
No, if you get the infection count low enough, you can investigate each individual case to death like Singapore has been doing it (though cases are growing beyond Singapore's ability to maintain this).
> Granted, there's the IMHE model, which somehow fantastically thinks the virus will mostly be gone in Santa Clara County in mid-May, but it's shown very little agreement with the actual data and is nearly as bad as saying the Easter Bunny will take the virus away.
Yeah, that IHME model.. It's unfortunate that it's become the model most people have become acquainted with. It has its uses, but the down-slope has previously generated critiques.
> 6. But this is a mix of two different processes, an acceleration phase prior to control, and a deceleration phase once controls are in place. Given that, why does the model predict symmetric death curves?
> 7. The answer is that this is a modeling assumption that the research team has made. They have chosen to fit a particular sigmoidal curve called the Gaussian Error Function (erf function, for short) to the data representing the cumulative number of deaths that have occurred.
> 13. The actual trajectory tracks the forecast pretty closely, but then starts to turn around. Once that happens, the back side of the curve is constrained to mirror the front side; the epidemic is predicted to wane quickly. By May 17, the uncertainty range collapses to 0 deaths.
> 14. This strikes me as unrealistic. Even ignoring the real-world coupling between states (this is not included in the model), I am not persuaded that the epidemic will necessarily be entirely finished in just over a month.
And a very important point he brings up:
> 16. In defense of the model, every model is a tool with a purpose. The primary purpose of their model is to predict peak health care need, not the endpoint of the outbreak. That said, people need to be aware of a model's purpose and be cautious when using it for anything else.
In other words, it's actually a pretty bad model* for predicting the down-slope. I fully expect that we'll hit 100k deaths for this first wave.
*unless the US were to have done a Wuhan-style lockdown.
Yup, but now #16 is no longer true. IMHE has entered the re-opening fray, and is setting target dates based on when they think we'll be down to fewer than 1 infection per million. It seems that it's driving public policy, and it's kinda ridiculous.
Decay seems to be very slow even in the jurisdictions with the strictest controls. (I do think the hardest hit jurisdictions may show something close to symmetry).
The disease is probably circulating in some subpopulations with Rt near or even above 1.0. Even if overall we're showing decay, those groups can continue to grow...
I also really, really, really don't like that if the peak is in the past, the model webpages claim that it predicted it perfectly; when really the webpage is just looking at the history.
> Decay seems to be very slow even in the jurisdictions with the strictest controls. (I do think the hardest hit jurisdictions may show something close to symmetry).
Agreed. Watching the graphs for Italy made this exceptionally clear. It's been a month since their peak in new infections, and they're just now hitting the 50% of peak level for new infections. And that's with a very strong stay-at-home order.
> IMHE has entered the re-opening fray, and is setting target dates based on when they think we'll be down to fewer than 1 infection per million. It seems that it's driving public policy, and it's kinda ridiculous.
Re IMHE, hopefully policymakers will listen to IHME themselves:
> We strongly believe decision-makers should draw on a variety of #COVID19 models.
> (That's not to let IHME off the hook; once they started promoting the ability for their model to do anything else, they became responsible for its predictions at other stages of the pandemic.)
San Francisco has only had 18 COVID-19 deaths in the last 30 days, and only 2 in the last week. [0] That seems amazingly low to me.
I'm leaning towards thinking non-essential businesses should be opened up there, provided they function under the same restrictions as grocery stores etc.
You could argue it the other way from the same data. Given that public health officials jumped on it early and got us such a low death rate, maybe we should keep trusting their judgment and let them decide when it's safe to reopen.
Unless the data shows that states/countries which did not lock down have almost the same cumulative health outcomes, minus the voluntary economic destruction.
Or perhaps they have radically different values and think one preventable death is one too many or perhaps they know a lot less about economics than random HN or perhaps they just don’t want to be blamed when more people die (even if it’s the right choice). Opening up society is a fundamentally political decision that I’m not personally willing to cede to unelected scientists.
You didn't cede it to unelected scientists. You ceded it to elected executive-branch officials, who then pick staff to work for them. If you don't like that, you can try to recall the mayor and/or the governor.
don't addicts die all day everyday in the streets of SanFran? I think the authorities are so timid because they know it can happen to them and they're terrified.
If that is the case then they could communicate that plan a little better. At the end of the day it's their fault if people don't understand why they are taking the actions they are.
It's an evolving situation. If they say precise but later-incorrect things, people will get mad. And a lot of the work they're doing is consensus-building, which is always mushy. Vague is fine with me right now if that's all they have.
If we continue to shelter in place we just push the curve out instead of flattening it. We need to start reintroducing people to society at a measured pace to actually flatten it.
Don’t misunderstand me, pushing the curve out has tremendous value in that we can better prepare but it also has a tremendous cost.
How many business and livelihoods will be ruined because we couldn’t reopen until a vaccine was available?
It seems crazy to sacrifice most of what makes this city great while the “smartest political minds” do what’s best for their career by transforming it into a partisan issue.
Gavin Newsome gave his criteria for reopening California, it doesn't require a vaccine.
Having people die in large numbers is always worse then some people going through tough times. It's unfortunate our national government is incompetent and making it political.
If the city is great it will bounce back. The bay area isn't the only place going through this, the whole world is
It's not a matter of dying vs not dying. It's a matter of people dying from covid or dying from stress related disease like heart attacks, suicide, etc with economic collapse. It's impossible to know before hand the exact prescriptive policies to minimize death over-all. Make no mistake, leadership is going by their gut on this. There are models, but the models are not precisely predictive, they are directionally persuasive.
Flatten the curve is to make sure there is enough available resources to help people who are sick. Nothings changed though, so opening things up means we'll likely be overwhelmed. Why take the risk to end up like any of regions that were hit hard?
So yes it'll be true for years, we need to learn to live with this virus, we haven't done that yet
"...opening things up means we'll likely be overwhelmed"
Only if you myopically believe there is only one way to "open up". But no one would believe that since it only takes ten minutes to read about the dozens of different ways European economies have already eased their lockdowns in recent weeks. This is not and has never been an on/off proposition.
There are a thousand gradients between the current lockdown and "open everything up". Almost no one is arguing we should open everything. Hearing this false choice over and over is getting old fast.
Currently workers on beef production are getting sick and factories are closing.
Now you can go to parks, beaches, grocery shopping, order food. What do you so deperately need to do? Have a beer in a bar? 80% of americans dont want to have anything start opening again.
And when you do force things open again you force workers who dont want to go back to work and feel its unsafe to go back to start working again, theres no benefits to recieve.
What a bizarre thing to ask. As if we need some special justification for wanting the lockdowns to be both effective and as permissive as possible. It would be strange for someone to want restrictions to be more stringent just for the sake of stringency. Efficacy is what matters, and "more strict" does not necessarily equal more effective.
If we knew we could open up school for small children without causing an intolerable spike in the transmission rate, wouldn't we want to do this? Of course we would. That's exactly what's happening in Germany and Denmark right now.
The article you linked is well over a month old. You can google this stuff yourself since you clearly are not keeping up with the news.
The restrictions in Denmark and Germany for schoolchildren are elaborate and inventive. We should be working on something similar here. The size of the country is a red herring, as these are local actions overseen by local schools. Of course I would put my kids in schools with these kinds of safeguards. Children need school.
And remember, our goal is not to prevent all transmission of the virus, only to keep the transmission rate low. Some transmission is unavoidable, so we have to be smart, not mindlessly strict.
They have had their lockdown going for that long. It's disingenuous to present germany like they had school open the whole time. They only just partially reopened. It hasn't been long enough to say whether its been a good idea yet or not.
California has a plan for reopening. Newsom has shared it, its reasonable
If you can point to something about the situation that has changed since the shelter-in-place was initiated that would indicate it's not needed anymore, I'd love to hear it. The virus hasn't gone away, we don't have any medications to make it reliably recoverable, we don't have test + trace ability in place (anecdotally, even if you're symptomatic but not in seriously bad condition it's still very difficult to get tested, let alone if you're not), we don't have herd immunity, there is no approved vaccine, etc. If the Bay Area opens up completely, exponential spread kicks in instantly with a high replication factor and in a month it'll look just like New York.
We are not through this in any way, shape, or form, even if it sucks. We've bought some time. If we did reopen now we'd probably be better off than if we hadn't shut down at all, but it'll still rip through the whole population, and unless we're ready to accept that, we've got to keep measures in place.
I agree that opening up in a dumb way would let the virus rip through the population.
But we now know that surface transmission isn't as big a deal, and that spreading is much less likely when there isn't sustained contact. We also now have everyone wearing masks.
Given those things, I would think that any shop where you ordinarily go in for five or ten minutes and don't touch a bunch of things (shoe repair, sporting goods, NOT bookstores) would be very low risk.
Sure, if the shop is too cramped, don't open. Stick in some proviso in the order that nonessential businesses can only have 1 employee for every x square feet.
Yes, LA county has the majority of cases in California. They're down from a peak of 1482 new cases a week ago, but still have hundreds of new cases a day. I'm just talking about SF, where things seem to be under control.
I hate how the idea of reopening has split down political party lines. This is definitely not the time for partisanship. Now that Republicans have come out as pro-reopening, San Francisco will be the last city to reopen in the country. 0 COVID-19 infections will be too many.
You can't have the expectation of paying debts and simultaneously take away people's means for repaying it. Responsibility without control is cruel.
Growing up, my parents maybe would have had an extra $100 at the end of the month. My dad would have probably been out of work - given that, each month they were out of work would have put them in a year's worth of debt. A financial death.
I hear what you are saying, but I am glad I am not the one making the decisions about this.
It is clear that sheltering does reduce the speed of infection growth, but it is also very clear that sheltering puts enormous stress on individuals, families and companies. I have empathy for those who have to work at home while simultaneously home schooling their children, or families that are in economically over-stressed situations where they don't have an option to work at home, or for communities that don't have adequate running water and other resources.
No, the science doesn't "support shelter-in-place", because science in itself doesn't support any particular policy. Instead, the science is simply predicting a certain number of deaths or burden on the healthcare system, and certain public-health officials are recommending policy to minimize number of deaths, because their sole priority is to save human lives. However, someone else could look at that same science predicting a certain number of deaths, and say that such a number of deaths is an acceptable sacrifice and a policy of reopening the economy can be pursued.
Good point. I've seen this mistaken notion of science a lot recently. Scientists can describe the world and make predications about how it might behave, they don't have anything to say (as scientists) about what one ought to do.
Also, it appears that by "science" commenters here really mean epidemiologists or medical scientists, not economists, psychologists, political scientists, etc. Scientists from each of these fields have a limited perspective, a good leader tries to balance these perspectives when choosing a course of action. Of course, the medical view matter a lot now but its not the only view that matters.
I hate how the idea of reopening has split down political party lines. This is definitely not the time for partisanship. Now that Democrats have come out in support of gradually tapering the quarantine, Republican mayors will be chomping at the bit to reopen their cities. 60,000 COVID-19 deaths will be too few.
I have confidence in the leadership of California. They have shown intelligence and restraint in the midst of this crisis, saving perhaps thousands of lives in the process. The federal government? Pure drivel, 24/7. The only policy they have is wishful thinking with a side of word salad.
The new order includes several approved low risk activities and transparent indicators that will be used to gauge safety to further reopen. Is there something about this you don’t feel is backed by science?
At the end of the day it is going to be a judgement call by someone - hopefully informed by scientific fact - but ‘science’ doesn’t say when to reopen, just provides the data and context help make a decision.
The original order was never based on any sound science to begin with. That doesn't necessarily mean it was a bad policy. But it was a faith based policy, not evidence based.
What’s not sound science about separating people to slow down the spread? It’s the only real option for anything like a quarantine with such a long incubation time (and as recently discovered asymptomatic infections) and the absolute lack of tests we had at the beginning of this outbreak...
It’s simple math that reducing the number of people in contact with each other would reduce the number of people that got infected.
> “ What’s not sound science about separating people to slow down the spread? It’s the only real option...”
no, that’s the nuclear option, not a surgical strike, much less the only option, and based on an insufficiently precise perception of the problem.
the mechanism of spread can be crudely described as spitting into each others’ mouths, not standing nearby, touching, or breathing in the same room. with the problem sufficiently, if crudely, framed, it should be easier to imagine other ways of preventing spread besides locking everyone in their abodes. physical distancing by itself, for instance, is probably sufficient for most folks. for “essential” workers, you might add a mask.
In the US they tried the just stay apart message before the stay at home orders and it wasn't working, people still crowded onto beaches in Florida over spring break and into concerts and restaurants all over the country. Ideally yes you'd just say stay apart from people and hand out masks which were getting sold out in a lot of places.
Without ordering places closed there's too much incentive for businesses to fudge and force their employees to come to work. Don't forget there were runs and shortages of masks so service industry employees wouldn't have complete reliable access to simple masks.
> the mechanism of spread can be crudely described as spitting into each others’ mouths
Somewhat true but coughing etc makes loads of the tiny particles that can carry the virus and they can linger and spread.
There's a lot that could have been done better but it requires a level of coordination and action the US isn't super great at, both in general and right now in particular..
> "There's a lot that could have been done better but it requires a level of coordination and action the US isn't super great at, both in general and right now in particular."
the US, by construction, is all-in on decentralized solutions, and one of its strengths is resisting unwarranted coordinated and centralized action, which is simply an amassment of power, because that's inevitably destabilizing (usually over long time periods, which humans have a hard time properly and understandably rationalizing about).
what's generally warranted, at a national level? defense and international relations. centralizing power is so threatening to the existence of the state itself, we limit it to other mortal threats to the state (international relations are centralized so other nations, say, russians, don't pick apart the states).
we are obligated by our forebearers to apply our ingenuity and our massive resources to finding a solution given the few constraints placed on us by the constitution. we do that by applying our brains, teasing apart the problem, trying solutions, and generally being good people. we don't go running to the apron strings of the nanny state.
I know it’s intentionally made into a diffuse set of states but there’s far more than just those two issues where federal power makes sense, environmental regulation in particular since air and water pollution don’t stop at state lines.
But we’re getting off on a tangent about the fundamental design of the US government made at a very different point in history. I don’t think either of us can convince the other here before we both wind up [dead].
On the topic of bungled mismanagement there’s things like states being forced to bid against each other for various medical supplies on the open market and then after being paid for the federal government taking those supplies to redistribute. Instead of those steps just buy them all an do the distribution based on the need in each state which won’t be tied to how much they have to spend. We could have started programs earlier this year to increase the supply of PPE and ventilators knowing that this would inevitably come to the US. We could have followed through on programs like this [0] to ensure that there were cheap easy to build options for ventilators instead of allowing the existing companies to buy out the company contracted and then get out of the obligation because ‘it wouldn’t be profitable enough.’
ok, but supply of PPE and ventilators to medical workers mainly concerns treatment rather than transmission.
stay-at-home and physical distancing primarily concern transmission.
we want to control transmission to reduce death and suffering, not eliminate them. even with dystopian and draconian measures (not to mention economy-destroying), reducing death and suffering to zero is effectively impossible (and seasonal recurrence is highly likely). moreover, the US is simply not designed, for good reason, to willingly tolerate such measures.
life is full of (similarly likely) risks, and we don't generally panic over them. if this were plague-levels of bad, more draconian measures might be warranted, but this isn't that.
sub-linear transmission is likely the best we can do.
with that in mind, physical distancing (combined with other carefully targeted guidelines like quarantining the sick and having workers wear masks) doesn't need to be perfect to be effective at reducing transmission to sub-linear levels. people who are likely to cough for any reason are already highly discouraged from going out, and most people in public are already hyper-aware of not coughing openly, especially not into each other's mouths.
stay-at-home doesn't meaningfully decrease the risk further, but it's a huge risk to social order.
Its all about the level of risk, which many of us are not so confidently dismissing. Everything follows from that. To assume its 'probably going to be ok' is potentially callously condemning a million people to die needlessly. All for lack of patience.
"life is full of (similarly likely) risks, and we don't generally panic over them. if this were plague-levels of bad, more draconian measures might be warranted, but this isn't that."
So if the IFR holds up at around 1%, and herd immunity ends up being the only solution since vaccines are tough, the pandemic in the US would be quite bad, no?
Help me see where the following is flawed:
Population of the US:
328M
Herd Immunity infection total (generously assuming 60%):
196M
So with 1.97M dead Americans, and 17M seriously injured (but surviving) fellow citizens, what exactly would you envision plague-levels of bad? What would be the economic damage from this level of bad?
Even if the IFR is off, closer to the flu at 0.1%, the infectiousness of this virus means we'd still need 60% or higher infections for herd immunity. With this IFR, we'd still have 17M hospitalized with serious effects, and still have 197K dead. That's at flu level IFR.
The economic value of losing 2M people, as well as 17M with shortened life spans would be far worse than what any lockdown we've implemented would do. It will take all we can to maintain social cohesion for the next 12 months.
As someone once said, "The Constitution isn't a suicide pact." It and the USA has changed dramatically over the last 246 years. Both the Constitution and the USA will change over the next 246. This idea that the Constitution is inviolate and perfect, that it's the only thing we should adhere to is nonsense, and has been since the ink on it was drying.
You have stated a plausible hypothesis. That's one step in the scientific method. Now do the rest of the steps. The actual math isn't so simple.
We all understand that in a crisis sometimes leaders have to take decisive action based on incomplete data. That's fine. Just don't dress it up with some fake veneer of "science".
No, we know limiting person to person contact will limit spread of diseases. The stay at home orders are a blunt instrument but they're implementing a very simple, well understood mechanism for reducing the spread of diseases.
I think the rest of the steps were done long ago. That’s when we discovered about infectious disease. Taking steps to slow spread is based on that science, AFAICT.
Sometimes the scientific process isn’t an option and intuition is required. Look at the results and tell me you would have preferred they waited in the name of science. SF could have been much closer to the situation in NYC...
Maybe we’re splitting hairs. I agree that it wasn’t “sound science”, but one could argue it was evidence based - the evidence being reports/video coming out of China (I believe there was an article in The Atlantic stating this is what made London Breed issue the first shutdown in the nation). Your use of “faith” based implies to me there was zero evidence taken into account which seems unfair. Again, maybe we’re splitting hairs and trying to agree on the same thing.
I think your logic around the word "intelligent" is overly simplistic. Would you say Sweden's logic behind their limited lockdown was not backed by "intellect"?
Just over a month ago, you were talking about Japan's reduced rates of COVID-19 cases thanks to their mask-wearing culture compared to western societies.
Would you like to revisit that topic before we talk about reopening anything? Or how about Hokkaido facing another wave of cases due to reopening too early? Because it seems to me it's only a matter of time for any country that's currently open to see a spike in cases regardless of their culture.
Its disappointing that you bemoan the partisan politics in a time like this and immediately assume/mock that San Francisco will take a partisan decision when so far they have done a good job and stuck to science.
If many people get very sick simultaneously, they would not only overwhelm hospitals, they would also inflict a disorderly, involuntary shutdown of large swaths of the economy, driven by fear -- instead of the orderly, voluntary shutdown we have at present, driven by government mandate.
On the flip side, NYC just showed us they can suffer through 20% of the population becoming infected at about the same time without their hospitals utterly collapsing.
There is probably some happy medium somewhere. For certain, flattening the curve so much that there are just a few new infections every week is not how we end the lock down.
It's only orderly so far because of a) food supply has not been affected yet*, and b) the gov issued unprecedented bailouts and put money in the hands of many people/businesses. However, we can't just keep printing money forever, if this goes on another 6 months it could be a whole different ball game.
Of course inflation will eventually eat away at its value, but at the moment we have the opposite problem, namely a deflationary spiral, because people aren't buying.
No inflation arises from injecting more money in the system if the amount injected is offsetting a reduction in economic activity. As activity increases, you take money out of the system (Raise rates)
nostromo's comment may sound like a joke but the reason why those two things in particular are inflated is the fact that the printed money is only available as a mortgage or student loan. Nobody is buying consumer goods with the printed money and therefore we don't get to see inflation (which by definition only looks at consumer spending). We might get to see "real" inflation if that printed money is used to pay for unemployment benefits or to pay salaries.
This misses the point that every country is printing money right now and yes some of that money is going directly to unemployment benefits and to paying worker salaries. At least in the USA 🇺🇸 it has...
There seem to be lots of people that think actual chaos is the only sufficient justification for a shutdown. No averting anything, let it get bad and mop up afterwords.
I'm surprised we're not seeing plans for some businesses to reopen with restrictions. I think it will be a while before we allow haircuts and manicures again, but I see no reason why we can't increase the types of businesses allowed open. Limiting occupancy, requiring PPE, and enforcing social distancing appear to be reasonable requirements. I hope the politicians and government workers are busy trying to find a middle-ground and not just playing it safe to cover their asses.
The thing I'm confused by is why a costco is open that has like 1000 people per day and a flower shop that has 20 customers per day isn't open. Is the flower shop dangerous? Is it less essential on the yearly timeframe? This lockdown isn't measured in days right now, it's measured in months. What's "essential" in days is not what's "essential" in months.
Another thing that I find funny is how haphazardly the social distancing rules are enforced. At Costco when entering the store, they have you get into an external makeshift line and stand 6 feet away from the next person while waiting for your turn to enter the store. BUT, once you enter the store, there's literally not a single person enforcing anything, and so everyone is just mashed together walking around as if nothing changed...
Waiting in line means extended contact. Brushing past in an aisle is 'momentary proximity' and while not ideal, represents a lower risk. Also, one is easier to enforce than the other. So there you have it.
Went to the Costco in South SF today and there were employees with megaphones reminding folks to maintain social distance near the produce, meat and deli sections.
Shouldn’t the metric incorporate the risk each activity entails? A good example is gardeners. Gardeners work alone or in teams of two, can obey social distancing, and generally don’t even talk to their clients on a regular basis. What is the threat here? What is so magical about the word essential? On the flip side large alcohol stores like Bevmo can stay open and serve hundreds of customers a day because they sell cheese and crackers and somehow that makes them ‘essential’.
It doesn’t make any sense, unless the true goal is enforcement through fear and propaganda. Disrupt people’s lives enough and they’ll start to think that the alternative must be truly terrible. That’s why you get articles claiming that even young people are susceptible where the simple math shows that the risk is low. Cherry-picked stories about the handful of children who died from the virus, instead of articles about the kids going hungry because they can’t get two free meals a day. It’s fear-mongering as public policy.
1) Liquor stores are kept open because a (surprisingly high) percentage of the population are severe alcoholics and sudden withdrawal can kill them.
2) No public health professional has time to list and quantify all of the routine processes of every profession to create a complex matrix of risk. And 99% of the public would ignore that matrix if it was created and published. The simpler and more effective public health communication is "stay home."
3) Your hypothetical pair of gardeners might not see their clients that day, but they still get up, get breakfast, get supplies at the store, fuel up their truck and equipment at the gas station, drop off a check at the bank after work, etc., and they can interact with other people at each of those stops.
4) Articles about young people that die from the virus are not trying to hide "simple math that the risk is low." They are trying to convince young people that the risk is non-zero, to prevent them from spreading the virus while pre- or asymptomatic.
5) "Children dying from a virus" and "children going hungry because they can't get two free meals a day" are BOTH public policy issues. Dooming an extra hundred? thousand? ten thousand? people to severe illness and death to avoid having to deliver emergency rations and meals to a million people is a false dilemma. In my medium-sized US city, schools and other community agencies have been distributing meals and rations for seven weeks now and we have zero cases of death by starvation.
Alcoholics are a pretty resourceful bunch, I’m sure they can find their local Wal-Mart, Target, or 7/11. Nobody is going to die because Bevmo is closed.
As to your point about selectively closing businesses being hard, isn’t that a good thing? We shouldn’t put tens of millions of people out of jobs because it’s easier than enumerating what can and can’t stay open. The burden should be on the experts to make their case; after all they have had more than a month now to figure out a plan of attack.
How many deaths due to coronavirus are too many? Right now it seems like public health experts are taking the view that any death is one too many. And they’re willing to present or skew the facts to get that point across. I would rather them be upfront about the benefits and risks, rather than take a paternalistic viewpoint. There are real costs to keeping the country closed, and we shouldn’t discount them.
Are you a real account? Essential is essential. Food. Gas. Home goods. Infrastructure. Anything that supports essential business.
Alcohol is certainly an outlier, but there are plenty of reasons for it to be essential. Alcoholics would die, for one. Black markets would spring up, for two.
Gardeners are not essential. No one is going to die because they can't get their gardening supplies. The cartel isn't going to get in the tulip business.
Alcoholics can go to their local Wal-Mart, Target, or grocery store. They don’t need specialty liquor stores.
What about weed dispensaries, are they essential? More essential than dentists, pediatrician visits, and the accompanying vaccinations? Because the latter have all been closed. How are construction workers essential when gardeners aren’t?
‘Essential’ is in the eyes of the beholder, it seems.
I'm not convinced you're arguing in good faith, but I'll dispel the misinformation for others:
In the bay area dentists and healthcare professionals are exempt from the order. My dentist is open for emergencies 7am-7pm. If your dentist is closed, you can certainly call and complain, but it's not part of the bay area order.
I'm not sure about vaccination schedules because it's hard to google it without talk about a coronavirus vaccine, so you should contact your pediatrician about that.
Construction is also essential only, except maybe the affordable housing exemption. You can report violations on sf.gov.
Weed has legitimate medical purposes, and keeping dispensaries open is probably a combination of that and preventing a black market.
My source for this is my own life. My town (San Mateo county) is still bringing in construction workers to build a playground. My pediatrician and dentist have both closed for non-emergency purposes, as has my physical therapist. And you didn’t even address my point about liquor stores - read the order from San Mateo county and see if you think their rationale makes sense.
I’m not sure why you think I’m arguing in bad faith just because I happen to disagree with you, but I’d appreciate you discussing the substance of my claims and not your interpretation of my intent.
The original thing I was pushing against was your "What is so magical about the word essential?" comment.
I've been showing how, with limited exceptions, it's not just a magic word attached to activities.
I didn't think you were arguing in good faith because you brought up horrible counter examples (gardeners??) and started spewing conspiracy theories that the bay area has some nefarious reason to keep people from being productive other than public safety.
You don’t seem to be reading my posts carefully, so let me spell it out for you. My point is that essential is seemingly arbitrary. Constructing a playground is essential but gardening isn’t. I can drink away my pain or het high but I can’t get physical therapy.
It doesn’t take a conspiracy theory to understand what’s going on. Essential has been defined narrowly enough to keep the public inconvenienced so that they stay vigilant. If you disagree with me on this go read the New Yorker article on Seattle’s response. Optics plays as large a part as science when it comes to public health.
Essential is also defined broadly enough so that big businesses and their lobbyists don’t complain. That’s capitalism, you can disagree if you want.
Not every argument has to resort to name-calling and accusations of being fake. Even on the internet.
And my point is that it's mostly not arbitrary, with a few exceptions that should absolutely be called out. And you are right to do so.
My problem with your arguments is that instead of complaining to your public officials that non-essential construction is happening (the park), you assume there's some conspiracy going on. Big Park lobbying? I don't know what you think, and I'm not going to bother writing out all the reasons it's ridiculous.
I guess we’ll have to agree to disagree. A reasonable person can read my posts with some nuance, but you seem determined to take the most absurd interpretation of my words while simultaneously putting words into my mouth. It’s not worth the effort to argue with someone like you.
What numbers are these lol? Why compare a single flower shop to all Costco locations including office workers?
There's thousands of flower shops and thousands upon thousands of other shops like flower-shops that have low amounts of foot traffic that make social distancing easy while supporting people's livelihoods.
It was a half-assed comment that maybe the Government see's saving Costco as more important than saving the Flower Shop. 95% of what Costco sells is non-essential, yet they are open. There's more at stake. Just a lazy comment though :D
by enacting these rules they create distancing in society by default. At least way more of it. Yes costco may be 'crowded' but generally MORE people are staying home and not going out because many places are closed.
From what the SF and CA governments have been saying, that's definitely next. Part of the goal of having mask orders now is to get people used to it. But until our test-and-trace capacity exceeds the rate of new infections, putting more people on the streets is only digging the hole deeper.
Switzerland actually started reopening with haircuts and manicures.
Certainly pressure from groups representing hairdressers was a big part of it, but the justification they use is that contact tracing can be done reliably in such a situation.
Keep in mind that they also want to reopen schools, citing dubious claims about children not contributing much to the spread, staying silent about the likely true motivation (sending the parents back to work).
The science on children not being significant vectors of COVID (and, by extension, school closures not being very effective) is actually reasonably well established:
That's not quite accurate, according to the article:
"“While school closure as a measure on its own is predicted to have a limited effectiveness in controlling Covid-19 transmission, when combined with intense social distancing it plays an important role in severing remaining contacts between households and thus ensuring transmission declines.”"
> Switzerland actually started reopening with haircuts and manicures.
I've been saving a ton of money without going for dye jobs, highlights, root melt and cut every other month, monthly esthetician and biweekly manicures.
I'm almost considering growing out my greys during this, although would be subject to ageism in my industry so sort of on the fence for now.
The local public health departments need time to get testing and tracing working. It is the only way to open up safely. We are way behind the Asian countries that learned the lessons of SARS.
why haircuts and manicures? Its a low population setting (1:1). If there is proper hand washing between clients, each new client gets a squirt of sanitizer, and both clients and stylists wear a mask? Require every haircut to start with a shampoo for mechanical disinfection.
That's a decision for those in government, but personally I see it as a balance of risk vs reward. There is a high risk of infection and relatively little benefit. It is probably better, for society as a whole, to pay the unemployment payments and have long hair for a while.
Shampoo doesn't remove the virus from one's lungs or exhalations. I'm not sure what benefit shampoo would have over, say, gloves. PPE is good but hairstylists aren't usually trained in its proper use.
I would hope dentists' offices reopen before hairstylists. Dentists are presumably more able to properly use PPE and disinfectants.
> PPE is good but hairstylists aren't usually trained in its proper use.
Higher end salons use PPE for keratin treatments and offer them to their clients due to the straightening chemicals (allegedly not formaldehyde but many products still contain).
Also, nail salon techs had been starting to wear masks and even face shields due to powder coating and dust from dremeling gel coating and acrylics.
I don't think there would be a high barrier to entry to transition wider PPE rollout across the field, because it's already implemented among some of the treatments.
” There is a high risk of infection and relatively little benefit. It is probably better, for society as a whole, to pay the unemployment payments and have long hair for a while.”
Citation absolutely required. We’re talking about people’s lives here, and there’s zero evidence for this kind of intervention.
Everyone says they’re “listening to the science” to make these kinds of decisions, but where is it? Why can’t we be letting people get haircuts while wearing masks?
Particularly in a place like San Francisco, where there have been 1,400 cases total and 23 deaths. It’s simply irrational now, and a lot closer to virtue signaling than anything with a scientific basis.
Don’t just downvote: provide affirmative evidence.
> there’s zero evidence for this kind of intervention.
Citation absolutely required. While there is definitely a ton of uncertainty around what causes spread, the one thing that there seems to be broad agreement on is that sustained time in a shared pocket of air with an infected person is the most likely transmission vector.
The virus is tanking the economy, not the lockdown. Air travel is down 97% even though they are no laws against flying places. You can lift the lockdown if you want, but if people are too afraid to board planes and go to restaurants and bars, you are not going to magically bounce back to 4% unemployment and 2% GDP growth overnight.
> If you want to take people’s livelihoods away from them, you have to justify the seizure, not the other way around.
Conversely, you could argue that if you want to take actions that risk killing hundreds of thousands of people, then the onus is on you to prove that your actions won't cost hundreds of thousands of lives. You can't claim that enacting a lockdown requires scientific proof but lifting one does not, when the potential consequences for the latter are even higher than the former.
> Sure there is. It's called mass unemployment and closure of non-essential businesses. Why would people fly to branch offices if they're closed?
Sweden didn't "lock down" (as people often point out), but travel is down 90% from normal [1]:
> "The biggest myth and misconception is that life goes on as normal in Sweden," she said. "It absolutely does not."
> "We have seen Easter travel decrease by 90 percent, we have businesses going bankrupt, a record number of temporary layoffs, and a lot of unemployed people."
I agree that lockdowns seem to have limited or no impact, but not for the reason you think. Where I am, restaurants and retail shops were already in dire straits before the lockdowns came into force. I think the lock downs have limited impact because they aren't very different from the way most people would be behaving anyways, given the information they have.
> Particularly in a place like San Francisco, where there have been 1,400 cases total and 23 deaths. It’s simply irrational now, and a lot closer to virtue signaling than anything with a scientific basis.
I live in a state with a very low number of cases and deaths, much less than SF. We began the process of reopening today. Which would be fine if our borders were sealed, if quarantine for travelers was enforced, if our systems for contact tracing and testing were adequate. However, none of these requirements have been met. It is only a matter of time before this state, which relies heavily on tourism, sees a rebound of cases and we are once back in the situation we were in a month ago.
We don’t even have enough PPE for current use levels yet do we? I hope people are trying to solve issues like that too, but I feel we’ve got quite a ways to go.
especially for the businesses who are struggling. At least let the most desperate ones open up and get some income. Gov should have some compassion on the small businesses that depend on monthly incomes.
You can start opening things up, it doesn't mean people will go out to eat, get haircuts, visit movie theaters, workout at a gym or travel. As long as the virus is out there and actively spreading, people will voluntarily shelter. Businesses will still go bankrupt as most retail stores and restaurants run at around breakeven in net income. Also there is the liability issue. If we want to get back to normal getting community spread to 0 should be the goal and we need to keep everything locked down to achieve that.
Is community spread of zero a worthwhile goal? SF still has thousands of people (maybe tens of thousands) coming in and out of the city every day to deliver things, see family, return home, etc. As long as this is still happening (there is no way for SF to prevent this) what is the point of fixating on zero new cases.
Consider two cases:
- On May 15 SF has had no new cases since May 1st. It decides to reopen.
- On May 15 SF has had 150 new cases (ten a day) since May 1st. It decides to reopen.
By June 15th, is the total number of cases any different under these scenarios? In either case, has the city been able to function without having to reclose?
I'm not sure the answer to these - but my instinct is that the situations would be virtually the same.
Community spread of zero is not the goal. The goal is to get the transmission rate below 1. A transmission rate of 1 means no average 1 person infects 1 other person. You need a transmission rate below 1 to start reducing the rate of new infections. Above 1, you have exponential growth. Right now we are hovering around 0.9. To reopen we need a rate of about 0.75. For comparison the lockdowns in Wuhan achieved a rate of 0.3.
Wuhan is a good example why community spread of near 0 is the primary goal. The restaurants have opened but are struggling because people are still afraid of getting sick and have changed their behavior.
White collar jobs will keep telecommuting if there’s a risk of community spread. No hr/leg department wants the liability. The secondary effects are decrease in demand on automobile related businesses like gas stations, servicing. Also decrease in car sales. Also the company ban on business travel which hits airlines, hotels, conferences etc.
I don't follow the example. If people in Wuhan are still avoiding restaurants, it can't be because they haven't reduced community spread enough - the city's reported no new cases for weeks.
That's my point. Wuhan demonstrates that reducing community spread to 0 has nothing to do with restoring confidence or reducing fear. In a year, I expect the regions aiming for 0 community spread will still be devastated, because they've taught their populace that the coronavirus is the worst thing ever and they must be constantly scared of it.
>> If we want to get back to normal getting community spread to 0 should be the goal and we need to keep everything locked down to achieve that.
Do you know what that will cost both in an acute USD fashion as well as the geopolitical and economic chronic fashion? I'm legitimately interested if you've thought through the externalities of this plan.
Economy will crash even if we open up and 50% of the population can’t participate due to age or having condition like obesity, diabetes or hypertension. People will continue to voluntarily shelter. Only way out of this getting Is community spread to near normal so we whole society can participate. Other countries have achieved this and will dominate economically. We are going to have food shortages because of our lack effort to control the virus.
I have seen many arguments with this same problem:
>Economy will crash even if we open up
This invites us to think of economic crashes as a do-or-don't function. This oversimplifies, and prevents us from thinking through the various degrees of "opening up" we might attempt, and the various kinds of economic harm we will suffer in different scenarios.
>People will continue to voluntarily shelter.
Some people will. Some people already were, for other medical reasons. The question is how many, and how much of an impact this will have (both in terms of controlling the disease spread, and harming people's physical health, emotional health, financial health).
"getting community spread to 0 should be the goal "
That is no one's goal at this point. To imagine it is would be to completely misunderstand this pandemic and how it is being addressed. The one and only goal is to reduce the rate of the spread, and it has seemingly worked very well.
People forget that there is no law which can put everyone under house arrest. This is all done voluntarily.
Why is it ok for people to shop at Walmart and not at their local small business that sells the same goods and is better equipped to enforce social distancing, with customers explicitly opting in to visit the smaller store?
If a small business can protect workers and customers, and a comparable large business is already open, the small business can consider opening and preparing to litigate all the way to the Supreme Court. With video cameras ready.
There may be a few hundred bored lawyers who remember the US constitution and would take their case pro bono. The federal government recently said it is willing to join lawsuits against states, on constitutional grounds.
Obviously, the business in question should be carefully chosen to maximize health, legal and business outcomes. But with many businesses shutdown, there's a large pool of candidates to be triaged.
Almost none of what you said is true. This is not voluntary, there are laws which give these powers, essential businesses can stay open regardless of their size, recording breaking the law while conducting non essential business won’t help you in the supreme court, the federal government is saying lots and doing very little.
I read somewhere about a store who didn't sell "essential items", but they tried to begin selling those items and the local police prevented him from pivoting. iirc it was a small AZ town.
So you maybe read about a small town in Arizona? Ok, well I buy my water refills from a small store in the Bay Area that isn’t closed down. Do our anecdotes cancel out?
Unless there's a state-mandated quota on essential businesses, what's stopping a store from adding some essential goods to their inventory and merchandising? This would reduce the burden on other stores, i.e. increasing social distancing in parking lots and within the story.
Laws exist with the consent of the governed. When laws are instituted under premises (e.g models, intelligence) that are later proved wrong (e.g. data, WMD inspections), consent should not be taken for granted.
This is goalpost moving. Of course laws exist by the consent of the governed. Your original post claimed that there was no law, and that businesses should consider litigating to the Supreme Court, relying on pro bono lawyers who "remember their Constitution", despite the complete lack of Constitutional support for your argument.
If someone could interview them on the operational and regulatory logistics of that change, we could put that on github and build a playbook for other small businesses, sharing strategies across towns & states.
IANAL, but I know some of you are so I'm asking here. I've read that challenges to these orders will not succeed because of emergency declarations. The emergency declarations are supposedly backed by some law, correct?
Don't we have a document in the national archives that guarantees things like peaceable assembly and not prohibiting exercise of religion? Yet we have people being arrested or cited for assembling, and pastors being put under arrest for holding church? Is it the temporary nature that allows this to be done?
Regarding the law that allows this kind of stuff, how does that compare to a constitution which says "congress shall make no law ..."?
If you're really interested in the topic, the podcast "All the President's Lawyers" discussed that this week. But in short, you can't read a couple of sentences from the constitution literally and expect that to override a couple hundred years of judicial interpretation.
Regarding the first amendment in particular, one relevant area of law is "time, place, and manner". E.g., just because you have free speech doesn't mean that you can go outside at 3 am with a bullhorn and start ranting; the cops can rightly cite or arrest you. More here: https://www.mtsu.edu/first-amendment/article/1023/time-place...
Freedom of assembly (and to a lesser extent, at least by precise Constitutional language, freedom to exercise religion) have Constitutional protections (that may or may not be unlimited, depending on the justice you're asking). There is no Constitutional protection for running a business or being able to patronize a given business. So protests in public and worship may be protected, but your neighborhood bar is not.
Fortunately for lawyers seeking good test cases, there's a rather long list of businesses which have been shut down. California may have more religions per capita than most places.
State's usually have laws to the tune of "if X happens then the emergency is extra super legit and the governor's orders carry the force of law" where X may or may not include a legislature vote and these laws have been exercised sparingly and in good enough taste (i.e. in actual emergencies) that they haven't been challenged much so they live in the same constitutional gray area that many obvious affronts to the text of the constitution live in.
I'm not aware of any lockdowns which are specifically targeted at small retailers while competing large retailers are allowed to be open. Where I am the small coffee shops are closed for walk-in business, but so are the Starbucks; the difference is that small coffee shops are not able to pivot to a centralized delivery platform en masse the way Starbucks is.
I can speak to a few examples specifically. It's planting season now, and high business for nurseries. In Santa Clara County, they're closed by fiat. Lowe's, Home Depot, ACE hardware sell essential things (plumbing supplies, etc), so they get to remain open, in-store nurseries and all. So, if I want tomatoes, I have to brave the crowds at Lowe's instead of hopping out to my local nursery which is rarely densely populated even in good times.
Summerwinds got closed and has to do home delivery only per the site.
After an outcry Yamagami's re-opened for customers with limited hours (rate limiting, etc) this past weekend. Not sure if Summerwinds is going to get the same reprieve.
Neither is setup for online orders though. Summerwinds has a limited set of things online so you have to call. From what I've heard its very hard to get through on the phone because they're overwhelmed. I wish I could just e-mail a list and wait a week; but they're not doing that either.
I mean, that makes perfect sense. Your local nursery is not selling essential good like you admitted.
What is the logic of letting them be open? It is very difficult to produce a perfect list of all spaces and businesses that might be "safe"; hence the only practical way of doing this is by producing a whitelist of those businesses that can remain open.
Essential services is a great demarcator of that whitelist.
This is hilarious to me. In Michigan big box stores can't sell garden items or seeds. You can still get them from any other retailer that was open. People were protesting.
Come down south to Ohio, we've somehow managed to escape many of the zealotry on both sides. We'll have most retail open by May 12th if you need anything
Where I live (not the US) the same thing is happening, except that although the big stores are open they cannot sell nonessential items. They have those aisles roped off.
That's what's supposed to be happening in CA right now. The 2nd shelter-in-place order stated that, even if you are an essential business, you were not allowed to operate non-essential components of your business.
I'd be pretty pissed off about roped-off aisles. When other people in the store aren't very vigilant about maintaining social distancing, having the additional aisles to escape into is a big deal.
They could still use aisles for transit, but if you're a hardware store with a garden area, you'd just need to close that one section. Though I'm sure you could make a case that someone gardening in their yard is essential, because it reduces their grocery store trips if they're growing food.
Well there are plenty of catergories that make little sense. Why is Dick's Sporting goods closed but Walmart is open. Why is Kohl clothing store closed but Target is open. etc.
If nothing else, at least we'll come out of this pandemic with some clear Supreme Court decisions to clarify what emergency powers state and local governments actually have. One nuance that people seem to miss is that timing matters. So a very short restriction on Constitutional rights may be acceptable, but the court places increasing scrutiny on those restrictions the longer they remain in place.
> Attorney General William Barr on Monday directed federal prosecutors to “be on the lookout” for public health measures put in place amid the coronavirus pandemic that might be running afoul of constitutional rights. In a two-page memorandum to the 93 U.S. attorneys, Barr cautioned that some state and local directives could be infringing on protected religious, speech and economic rights. “If a state or local ordinance crosses the line from an appropriate exercise of authority to stop the spread of COVID-19 into an overbearing infringement of constitutional and statutory protections, the Department of Justice may have an obligation to address that overreach in federal court,” Barr wrote.
I'd love to believe that comes from a genuine appreciation of civil liberties and not from an election-year attempt to pander to the current executive's voting base.
> Why is it ok for people to shop at Walmart and not at their local small business that sells the same goods and is better equipped to enforce social distancing, with customers explicitly opting in to visit the smaller store?
Small local businesses in the Bay Area that sell similar items to Walmart are open right now, from hardware stores to produce markets. I imagine apparel stores are shut, though many around me are doing online and appointment apparel shopping.
If Walmart is the only store open where you are, it's likely the only store that exists selling essentials where you are, and that is a different problem.
State and local governments have far greater abilities to issue orders like this than the federal government. What, exactly, is unconstitutional about a city issuing an order that revokes the ability of a business to operate due to a health emergency?
On the surface there's not much constitutional protection for engaging in business but there would be some serious schadenfreude if Wickard v. Filburn showed up to defend individuals from state prosecution for once.
edit:
To expand on this, for an individual's right to do something to be protected from the states that right must be protected under the 14th amendment. Over the years the court has found that the 1st, 2nd, 4th, etc, basically all the big stuff is protected from state infringement under the 14th. In addition to this, for the incorporation of a right to under the 14th to have any teeth to this the court must have ruled that state regulation must pass strict scrutiny to be constitutional, in layman's terms it needs to be limited in scope to the bare minimum and there as to be a damn good reason. Unless you're willing to play some serious mental gymnastics there isn't any real combination of constitutionally protected rights and court rulings that restrict infringement on those rights that result in the ability to run a nail salon or other "clearly not essential" type business. Basically, no the constitution doesn't protect you from this.
That's where civil liberties advocates old nemesis comes in. In Wickard v. Filburn the court ruled that even non-business activity that is fully contained within a state is subject to federal regulation under the interstate commerce clause because it affects market conditions if everyone does it. If this sounds like an end run around the constitution it's because it is. Normally you see this ruling used (I'd love to say "abused" but is it really abuse when it's functioning as intended?) to micro manage how states regulate businesses or go over states' heads and regulate them directly. So it would be a more or less complete 180 to see the ruling used to justify the federal government not only prevent states from regulating but allow people to go about their business without being stopped by state regulation. I think this is highly unlikely but a) it's fun to speculate and b) if the rest of 2020 has been any indication, anything is possible. Also, it should go without saying but this analysis is not exhaustive, there would be more to the issue than this.
Dumb question: what did Wickard add to the interpretation of the commerce clause that wasn't already pretty obvious after Houston East & West Texas Railway Co. v. US?
Basically the intrastate effect of Houston East & West Texas Railway Co. v. US was said to be constitutional as a byproduct of regulating interstate commerce. Importantly the former is regulating commercial activity whereas Wickard v. Filburn expands the scope of the commerce clause to purely intrastate non-commercial activity that don't affect interstate commerce and would only affect interstate commerce if everyone did it.
Uh, there are plenty of laws to keep people in their houses. In my state, anyone outside w/o an excuse can be charged with disorderly persons offense at the very least.
We are down 50% from the peak of Covid deaths in California. It seems likely we will have one or more days of zero Covid deaths before the end of May. That is the measure I assume they are going for at this point.
This is untrue. We may have plateaued but we haven't yet seen a significant drop from the peak yet. 4 days ago there were 115 deaths, then 93 the next day, then 89 the next, that's as high as the peak you're referring to. Source - daily department of health releases https://www.cdph.ca.gov/Programs/OPA/Pages/New-Release-2020....
The drop you are inferring from your graph appears to be a be a reflection of a noisy data set, and the graph is a week out of date.
We should separate LA from ex-LA. Bay area has peaked.. if you exclude nursing homes (which the lockdown relatively failed to protect), it's even sharper of a drop.
Unless you intend to setup border checkpoints, with two-week quarantine camps for people traveling from LA to the Bay area, you have to look holistically at the region.
It doesn't make one whit of sense to ban flights from Paris, but allow anyone who feels like it to drive up from LA.
Yeah that's definitely a day-of-week/reporting dump effect making that spike. The 7 day rolling data for deaths shows CA is only 6% below the most recent peak:
Not to mention that death lags infection by 1-2 weeks, your site shows that pretty nicely (the lull in new infections several weeks ago mirrors the lull in new deaths).
We haven't crested the peak in death until a few weeks after we crest new infections, and it doesn't look like we've done that yet.
Remember death rates are an effect that's delayed several weeks. Positive tests are skewed by how many tests are done. Hospitalizations would be a better figure but those don't really seem to be available on a daily basis. This chart claims to show but it's 212 one day and zero the next, which just showing they're aggregate or something.
If I am reading the data correctly, considering total number of cases, and current rates of growth, the Bay Area is doing really well compared to the rest of the USA in terms of preventing the spread. [1] There will inevitably be areas that will recover sooner than others, and I could see the Bay Area being one of those places. How is the Bay Area going to handle that? Are these places going to station cops on county lines and screen people wanting to come into a "recovered" region?
Moreover, restrictions are not uniform. For example, San Mateo county restricts movement to within 5 miles of one's residence. Other bay area counties like Santa Clara do not. So legally somebody from Santa Clara county can visit San Mateo county (for exercise), but not the other way around.
A well-managed response would include curbs on movement, be it at the state or county level.
Definitely. A friend had been working in Malaysia and surrounding areas when all this got going. He had to quarantine 2 weeks in Malaysia before he was allowed on a plane back to his home in Amsterdam, and now has to self-quarantine for another 2 weeks there given the airports he passed through. I could easily see similar restrictions. E.g., anybody wanting to enter a Western Pact state might be required to quarantine 2 weeks upon arrival.
There's a good quote cited often on Strong Towns: "problems have solutions, predicaments have outcomes".
We're in a predicament. We blew weeks, maybe months ignoring the problem at the federal level, so now we don't have the PPE or testing and tracing infrastructure we could have had at this point that would allow some cautious, yet safe reopening in places. The stay home orders work, but they're devastating to the economy. Reopening in an unsafe way would be devastating to both the economy and public health: smart people are going to stay home anyway because they don't want to get sick and die.
There are no 'good' options at this point. Something like this plan seems like the best bet, but we need to get supplies and infrastructure on line as quickly as possible, and understand that the federal government isn't likely to be of much help.
And measures were not limited to Wuhan. By the time restrictions were lifted in Wuhan, the Chinese government had implemented quarantines, surveillance, contact tracing and testing procedures throughout the entire country. While here in the US we have a hodge-podge of approaches from each state with varying success, and no restriction of movement. Not saying we should adopt authoritarian policies, but we'll only have the virus under control when every US state has it under control.
This is bizarre... There is a statewide stay-at-home order in effect until further notice. Any less-restrictive orders, such as San Francisco's, are null and void.
It does allow them to implement more specific restrictions. For example, with today's extension, SF is closing more street to cars inside Golden Gate Park to allow people to exercise outdoors while maintaining a safe distance.
If we intend to keep the lockdown going until we reach herd immunity, then Congress needs to open the taps and let the basic income flow. Trillions upon trillions of dollars, for as long as it takes. And they might want to get medicaid eligibility ramped up as well. We don't have to call it single payer.
Both parties are corrupt, and both advocate for reasonable and unreasonable policies. Part of their power derives from convincing much of their base to despise the "other side", to never properly listen to the other side, and never fairly consider the other side's position. Politicians on both sides benefit from inflaming this dynamic.
Serious question: if restrictions aren’t lifted now then will they be? What will be meaningfully different June 1st rather than May 1st?
Is it shelter-in-place until we get more testing? Or the AppleGoogle contact tracing? Or is it shelter-in-place until a vaccine... in 18 months?
What are the conditions required to start slowly relaxing the shutdown?
Edit: I don’t understand the downvotes. I haven’t left my home for two full months. I started preparing for the worst in early February. There are many options in between “full lockdown” and “fully open”. We won’t be in full lockdown for 18 months. So, what are the requirements to start slowly lifting.
The recently stated goal is to decay to 1 infection per million residents so that robust contact tracing works. Back of the envelope math puts that between 6 and 18 months of continued progress of the health order to get it to this level.
(60 or so in Santa Clara County ICU == ~6000 infections. ICU occupancy decaying by 40% per month; 0.6^15 months * 6000 = ~3 )
If you look at hospital admissions, instead, it's a bit less than a 40% decay per week. So we get something more like 5-6 months.
I don't see either of these as plausible. And even if we have lowered Rt to this point of decay for most subpopulations, I'm better there's a few where it's higher and that will eventually shallow out the decline. Not to mention the risks from areas with lower controls.
The IMHE model is very influential, but it has been forecasting an unrealistically quick decline in cases that has encouraged public health officials to seriously consider trying to get to this minimal level of cases.
>> The IMHE model is very influential, but it has been forecasting an unrealistically quick decline in cases that has encouraged public health officials to seriously consider trying to get to this minimal level of cases.
It also blew their 95% CIs over half of the measured data points, with social distancing built into the model (so no moving the goalposts here). It's a worthless model.
You'll note there are no metrics or numbers, just platitudes and ideas.
That means it is up to Gov. Newsom and his interpretation of the facts and we are unable to hold him accountable. Which is generally how government officials like it.
Probably downvotes because the answer to your question is the same as to 90% of all uninformed questions online - "we don't know". There are so many unknowns, things go day by day or week by week at best. I too get annoyed at the 1000'd idiot asking 'but will I be able to go on holiday in August?'. Not saying you're an idiot, just trying to explain why others, like me, would be annoyed at your post and would want to see less posts like it.
Then it would be best if Gov. Newsom and the other elected officials put hard data and target metrics out, not platitudes and "we must get better before we reopen" statements.
Well they don't know, and neither does anyone else. So it's either throw out an arbitrary goal now, and run the risk of having to change it and people saying 'you keep moving the goal post', or not doing it and people saying 'there's no target or coherent policy'. There's no winning here.
Every couple of days there is a bitchfest on here about idiot managers demanding exact prognoses on software development projects, and then we all agree that because there are unknown unknowns, that's pretty much impossible. How is this any different, if not an order of magnitude more complicated still?
I think the main problem is people expecting government to know everything because - well, they're the government, probably? But they're just a bunch of people like you and me. The fact of the matter is that nobody knows that much. You can complain about that, but that doesn't change the fact that some things are just unknowable at the timeframes we're working on.
>> Every couple of days there is a bitchfest on here about idiot managers demanding exact prognoses on software development projects, and then we all agree that because there are unknown unknowns, that's pretty much impossible.
That's not what I - or most people - are asking for. We're asking for something akin to the agile product cycle. Give us blocks of time you are spending on the problem, tell us what you are doing in that block of time in a transparent and modular way, and tell us how much time per project you are spending and what you hope to accomplish in that time period.
It's... pretty simple. No one is asking Gov. Newsom to say "we'll be back in business in 4 weeks" but he's got to do better than zero data and zero transparency.
It doesn't seem like there really are unknown unknowns in this case though. You can just fix all your non-quantifiable assumptions at current levels, and set some numbers for the quantifiable ones. The problem is that any numbers you set that way either involve many deaths, or many months of lockdown, so no politician wants to say them out loud.
They don't want to be beholden to an arbitrary goal they've made in the past - they want to be able to move the goalposts forward or backward and (hopefully) translate the latest advice from experts into actual policy.
I agree with you though - some better expectations-setting would be nice, and probably encourage more people to comply.
You think it is acceptable that our government either: A. Has no plan behind what they are doing or B. Has a plan, but is refusing to share? Because that's my reading their press release. Please enlighten me why you feel that the current state of affairs in disclosure and planning regarding the future of the lock-down represents leadership on the correct side of competent?
This policy has outlived its usefulness, and is harming people's quality of life without a clear goal.
The initial premise of the "flatten the curve" memes was to avoid overwhelming hospitals. The shelter-in-place has not only had this effect, it's been too effective. Hospital utilization in the bay area is at around 10% when you count surge capacity that has been added [1].
Meanwhile, data is coming out to show that coronavirus has a very low fatality risk to anyone under the age of 50, and to anyone without pre-existing health conditions. A blanket shutdown does not make any sense when the vulnerable demographic has been clearly identified. How is it moral to order people to shelter in place when their risk of death is around 0.01% for 18-45 year olds.
Blanket lockdown doesn't make sense anymore. There is no risk posed to the majority of the population from covid-19. We need to switch to targeted approach, and let people get back to their lives.
Our political leaders (in California) are being fearful, afraid to take leadership and base their decisions on data.
I've seen you say similar things in a few other threads, and myself and others have said, every time: the risk to everyone is that the hospitals become overwhelmed. They are not right now because of stay-at-home orders. What you think of as failure - hospitals currently low utilization - is in fact success.
1. This doesn't appear to be a falsifiable position with respect to being overly conservative. Any action that results in the hospitals not being overwhelmed will be taken as somehow likely causing the hospitals not to be overwhelmed. It's not clear by this logic how hospital capacities are ever chosen given various uncertainties in the environment.
2. It commits a status quo bias. Only the risks of deviating from shelter in place are considered. On the one hand we have a virus with a CFR of around 0.5% with fairly well understood vulnerabilities to various parts of the population. On the other we have a completely unprecedented shutdown triggering a 2T spending package and causing record unemployment, with an unknown end goal. Is the risk of continuing down this path somehow less than the risks to the hospitals based on our knowledge of disease?
> with fairly well understood vulnerabilities to various parts of the population.
I don't think the virus is as well understood as you believe, which is why opening back up now may be premature.
Regardless, the riskiest pre-existing conditions appear to be obesity and hypertension. 57-75% of Americans are obese according to the dedicated Wikipedia page. Also bear in mind there is considerable variance among obesity rates per locale. What's the CFR in obese patients?
Edit: if you can't tell me the CFR in obese patients, you shouldn't be rushing to open everything back up. I don't know why people are silently downvoting but there is nothing incorrect or inconsistent about my comment and I'm just making a suggestion based on what little evidence exists.
Point is there will be more than enough cases to overwhelm hospitals if the virus spreads in earnest. In this respect our population is potentially more vulnerable than, say, much of Europe or parts of Asia.
I don't know why my comment is even being downvoted. There is literally nothing factually incorrect or logically inconsistent about it yet every time I post anything regarding COVID19 I get immediate downvotes.
The pandemic isn't going to stop anytime soon. Miracle cures are highly unlikely, and a safe vaccine is probably more than a year away. So I hope that anyone with obesity is taking this opportunity to lose weight at a safe and sustainable rate.
1. A lot of people are gaining weight at a prodigious rate.
2. Newly minted alcoholics are being created before our very eyes.
3. There are already a bunch of seriously bad haircuts.
And this is just among people that I know who have the luxury of sitting around the house working from home. I imagine the real life consequences for the less fortunate are significantly more serious.
> What you think of as failure - hospitals currently low utilization - is in fact success.
What bothers me is the contention that my rights are contingent upon reported capacity of already existing hospitals. If this is truly a concern, and our rights our primary, then we should be building more hospitals so that we no longer have to make this Faustian bargain.
It seems impractical and short-sighted to continue these measured based upon this single metric, especially when there are so many other ways to have a lasting impact on the problem.
Aside from that, I don't personally believe it's the purpose of the government to save lives at any cost. Even the Police won't give you that guarantee.
The last rounds of major public (or notionally public) buildouts of infrastructure where profits be damned were funded by the feds, because the states and localities do not have the financial resources to add this along to whatever else they are currently funding, and even if they did you'd see a patchwork that mostly fails the truly underserved.
This is extremely unlikely due to the current administration.
> What bothers me is the contention that my rights are contingent upon reported capacity of already existing hospitals
This is pretty selfish. What about all of the old and immunocompromised people that could _die_? What about the families of those people? These people deserve rights too and I’d say their right to _stay alive_ trumps your “right” to get a hair cut or whatever
Let the old and immuno-compromised shelter in place then while the rest of us build herd immunity. We don't shut down the tobacco or alcohol industry even though second hand smoke and DUIs kill orders of magnitude more innocents than covid-19 ever will. Millions of people die every year. That's never going to change - such is life. You gotta draw a line somewhere and I think the "save lives at all costs, even the cost of the nation's economy" attitude of covid-19 is too far. You'll pay for a ruined economy later in suicides and increased crime (not to mention suicides snuff out way more man-years of life than old people dying of sickness who were already nearing the end of their rope).
You don’t think that covid-19 growing largely unchecked, infecting millions of Americans and overwhelming our healthcare system won’t crash the economy and kill young people?
We have a lot to lose and betting it all on for the economy, which would likely be ruined either way, seems foolish to me.
I suppose I just don't believe that would happen. You can still practice social distancing/face masks/hand washing without shelter-in-place. I believe those three things alone would significantly slow down the spread to manageable levels. So I simply don't see a scenario where it "grows unchecked" to millions in the USA. It would hit millions eventually (like swine flu) but it would be manageable (not "unchecked"). Most of the US is geographically separated and not densely populated (except for cities like NYC), and we are only at 3M cases globally and that is with months of growth.
Lastly, even if it grew unchecked, I don't believe overwhelming the healthcare system would crash the economy. It might devastate the healthcare industry, but it wouldn't devastate all industries like prolonged, no-end-in-sight lockdowns are doing. I also don't believe it would "kill [significant amounts of] young people" because I believe the mortality rate is much lower than currently estimated.
Suicide is already killing more young people than covid-19 due to lockdown. 2 USAFA cadets committed suicide because of lockdown orders this month, yet 0 cadets have died from covid-19.
> What bothers me is ... my rights are contingent upon ...
Your rights have been an illusion the whole time. We're one organism. The individual is a useful abstraction, as is further dividing that into the cells, but these abstractions have limits.
> What bothers me is the contention that my rights are contingent upon reported capacity of already existing hospitals.
What rights do you think you have here? Businesses are controlled through licensing and zoning. Outdoor spaces are regulated. Which right are you referring to?
> data suggests the vast majority of the population have taken to voluntary social distancing, which is the crux of Sweden's strategy to slow the spread of the virus.
Does it make any difference if they have "plateaued" if there are more active cases today than yesterday?
Does it make any difference that the US has not "plateaued" if the number of active cases is rising slower than in Sweden, and the death rate is lower?
It's good to have numbers, but given the wide disparity in testing rates and protocols, it's difficult to come to any significant conclusions based primarily on day-to-day case count.
Death count is at least somewhat less subject to such complications, and even there, it'd be much better to compare 7-day averages to smooth over reporting quirks.
Well, this is a truism, but it also smacks of special pleading. When readily available data contradicts a line of propaganda or groupthink, you can rationalize why it has many issues and quite possibly be right, but why are you exerting yourself to rationalize in that direction and not the opposite one? Even weak evidence against something should not enhance your confidence in that thing!
If the numbers were really meaningless, it would probably be evident in their clustering or limited range. I noticed the contrary; I didn't post a complete chart because I figured more data would probably result in diminishing returns when urging people to question their beliefs.
Russia, by the way, in the same data set, has about 7.6% more active cases than yesterday. Brazil, 8.4%. Pakistan, 4.8%. So if you hypothesized that all the increases were in the approximate range of +1% to -1%, you would be quite wrong.
Conversely, Germany's figure is down 4.8% and Switzerland is down 6.2%.
It seems as though people for whatever reason fetishize Sweden, among other nordic countries, and I'm increasingly irritated by it. Partly because it reminds me of the current US president and his judgment of different countries as "shitholes" or not. People pretend that they are clearly seeing facts in an unbiased way while doing the opposite.
No one is advocating going back to usual. Just to stop the irrational hope and actions that seem to target impossible benchmarks - you can't eradicate the disease, not a chance - instead, learn to live with it. And you do that one step at the time, not locking down further.
Exponential growth also means that 10% utilization isn't a ridiculous amount of headroom: it's <4 doublings, each of a few days, from overwhelming the system with new patients.
An R0 of 2 is towards the low end of estimates without social distancing. Zhang et al. estimate it as [2.06, 2.52] from the Diamond Princess data; Sanche et al. reported [3.8, 8.9] from data from Wuhan.
Without social distancing or contact tracing. The Bay Area's r is probably around 0.8 at this point with Santa Clara even lower (EDITED - see notes below). Some restrictions can be relaxed.
Rt of .88 according to https://rt.live I agree some restrictions could be relaxed. Hospitals were a good first step. More of the outdoors could be a good next one.
If it creeps up to 1.1, you still don't need many rounds of infection to completely overwhelm the system. 7 rounds of infection (~a month) would result in 10.4x more total patients.
That's new cases though, isn't it? I was summing over the entire "tree" to get the total instead.
If R0=2 (each person infects two more), you have 1 case at time zero, two after the first time step, and four after the next, but the total number of cases is 1+2+4=7, not 2^2.
It's true that people are discharged from the hospital eventually (one way or another), so there's a little extra room from that, but not much.
California is somewhere near steady-state (R=1) right now, but that's not a "stable" point, in the dynamical systems sense. A small decrease below R=1 would lead to falling rates, but a small increase above R=1 can make them skyrocket.
I'm not sure if there's good data on the length of hospital stays, but an early preprint from China reported a median stay of 19 days. That's not much help here: On day 20, the intake is 60% larger than the initial cohort--and only half of them (b/c median) will be discharged.
People with more data and expertise!) have worked up full SIR and utilization models, but the general point is that exponential growth is manageable, even boring, until suddenly it suddenly isn't.
Note that is CA as a whole. LA is skewing it upward.
e.g. CA was around 1250 new cases 2nd week of April and maybe 1200 now (4% lower). With test capacity increasing, rt.live is giving 0.88, which on a 4 day serial interval implies a 33% actual reduction
Bay Area went from about 200 to about 140 now (30% lower). Factoring the reduction from testing (if same for all of CA), we're actually at a 53% reduction. That's an R of 0.81.
Santa Clara (which I admittedly originally mis-used for all Bay Area) went from 62 to 25. That's an crude R of 0.77 -- 0.7 factoring the test increases.
Various data points. This is an upper bound, more calculated for Santa Clara county.
International comparisons to lockdown level and case count changes.
Assuming serial interval of 4 and > 10x non-detection rate on March 31 and 3x now gives you this.
Knowing people were dying if the disease in early February implies very high lack of detection when SIP was in place. (Likely over 800 infections a day when Santa Clara activated SIP)
What is your evidence that hospitals in America in general, and in California, are anywhere near being overwhelmed? I've cited evidence which shows the opposite--they are very far from being overwhelmed.
I live in a county of little over 100K residents, one death occurred over the outbreak, a 91 year old person died of COVID19. Over the weeks we had a total about 65 known cases, all sent to recuperate at home, with a single patient in the hospital.
The hospital has an entire wing dedicated to COVID patients that did not actually materialize. No care is provided to other patients that might need it (unless it is an emergency). Every appointment was rescheduled months into the future.
Everyone must stay home on the account of better erring on the side of caution.
I just went to the ER last night for what turned out to be a kidney stone. The place was empty. The doctor had just learned that day that the owners had laid off 50% of the staff.
On 3/16 San Francisco and some other cities issued the shelter-in-place order, and CA had 472 patients. Two weeks later, on 3/30, CA had 6,932 patients. That's 21% average daily increase, with an existing shelter-in-place order.
With 21% daily increase, it takes 12 days to go from 10% to 100% hospital utilization. And change of policy usually takes a week or more to affect the curve. Which means, we are ~5 days away from an invisible deadline, after which hospitals will be overrun no matter what.
First, it's not clear or obvious that the 21% daily increase rate would increase indefinitely. Infection rate slows more people get infected, and new potential victims decrease.
Second, all regions saw giant, double digit growth rates at first, and then lower growth rates. Sweden is taking a more laissez faire approach, and their growth rate has dropped from over +20% d/d to +1% d/d [1]
There isn't data to support the idea that we'd have 100% utilization in the Bay Area without shelter in place.
They’re not near being overwhelmed. That’s the point of we are currently living in success. But what we know from Italy and NYC is that the margin between situation-normal and patients-are-dying-in-hallways is less than a month.
The one-size-fit-all lockdown was a reasonable first knee-jerk reaction given the situation. It isn't a tool to fight pandemic, it is just a breather to prepare the long-term sustainable tools and system - like production of tests, certified masks, etc., identifying/quarantining vulnerable population, putting contact tracing in place, adjusting various social distancing rules to be tighter/looser where it possible and makes sense, etc. - to actually fight pandemic. Yet it seems that the lockdown time has so far been almost wasted in that regard and the lockdown itself seems to be taken as the main tool to fight the pandemic (probably also coupled with the naive idea that this virus can be made to go away completely). That doesn't look good. We may get temporarily lucky - the hot and dry weather will slow down the spread until of course October/November when with such an approach we would be back to square 1.5 at best, and that if the virus doesn't mutate to become more virulent and/or deadly (the 2nd wave of the Spanish flu for example was more deadly than the first)
For example - the construction was stopped at near by site. It is a huge 3 acre site where you can easily set social distance of say 10-20ft and have the clad in PPE crew working without any risk of virus spreading.
Ease up how? I mean, what's the specific proposal? The lockdown isn't "total" anyway -- very large numbers of people are still working at full salary (including, it must be pointed out, probably more than half the readers of this very site). There's little to no low hanging fruit of safe jobs that can be reopened. Just go look at the California list of "essential" jobs and tell us what needs to be added.
Fundamentally this is just a complicated strawman. People are arguing against "lockdown" but not in favor of another option. But we were all here in late march and we know what this disease does without containment.
I'm not an expert. I'd lean towards loosening restrictions on non-essential businesses, imposing strict capacity guidelines, and adjusting the strictness of the guidelines by region at fixed intervals with a fixed lead time. Add some worker protections so people who don't feel comfortable working don't lose their jobs during when they reopen, and don't exempt them from receiving unemployment so reopening doesn't turn them into a burden for the nonessential employer.
I'm lucky right now, to be an 'essential' employee making roughly twice minimum wage, working for an employer with deep pockets. I'm not coming from a place of personal inconvenience, because my job's gotten exponentially easier since people became afraid to go out. Most of our part time staff is gone, and I'm worried that SMBs will soon start dropping like flies.
We've proven that lockdowns work, really well. now we need to find a balance in order to prevent the economy we as a society return to from being a small collection of megacorps wandering through a graveyard of small businesses and unemployment.
Shouldnt step 4 be actually first one as it has lowest risk of making anything spread? Meanwhile, kids in elementary schools are unable to keep distance from each other and opening them requires reorganization like need for more space, need have them in smaller groups etc.
1) Schools are about to be done for the academic year, so they're effectively shut down until August anyway. It wouldn't make sense to re-open schools for less than a month.
2) For better or for worse, we've conditioned people to be wary of contact with other people. A movie theater that's 10% full is still hemorrhaging money, perhaps worse than if it was closed entirely (no payroll costs/etc).
I'm not sure what the breakdown is, so this could certainly be hyperbole, but it's entirely possible that people will just feel uncomfortable doing things with groups of >10 until a vaccine is available. A restaurant with 25% of its normal business will likely still need to shut down, reduce staff, etc.
Sure, we may not have 22MM people filing for unemployment but it might still be 10MM, which is still extremely abnormally large.
All that to say, there's a real possibility that gradual re-openings don't actually accomplish anything because the root fear (i.e. catching covid-19) hasn't been resolved in the minds of many people, especially in dense urban areas.
> 1) Schools are about to be done for the academic year, so they're effectively shut down until August anyway. It wouldn't make sense to re-open schools for less than a month.
Though it could make sense to re-open them a month early, health concerns permitting. They already got a "summer break" and can make up for lost time
My kid is absolutely still participating in school, and quarantine is pretty stressful for a kid. This hasn't been just loafing around, relaxing, and playing.
> Ease up how? I mean, what's the specific proposal?
Not sure how to put this but if you're advocating for the side that wants to confine seven million people to their homes and shut down nearly all commerce you're the one that has to come up with the specific proposal.
The objection is that there doesn't seem to be any kind of numerical metric to determine the success of this shelter in place policy.
It's public policy. So what are the stated goals of that policy, and what are the criteria for determining success?
It is a serious fucking problem that people aren't even really trying to answer that question any more.
That doesn't seem right. I got tacos from down the street last night. I got paid a week ago. I bought some home office related junk from Amazon yesterday. I need to go shopping tonight.
That's the problem with not being specific, you find yourself spouting silly hyperbole instead of argument. No, "almost all commerce" isn't shutdown, that's not remotely true. We're looking, depending on how pessimistic you want to be, at like a 20-30% drop in GDP. And that's big, but it's simply not almost all.
So I ask again: who do you want to go back to work before the virus case load drops? Be specific.
> That's the problem with not being specific, you find yourself spouting silly hyperbole instead of argument. No, "almost all commerce" isn't shutdown, that's not remotely true. We're looking, depending on how pessimistic you want to be, at like a 20-30% drop in GDP. And that's big, but it's simply not almost all.
You're kidding right? The drop in GDP between 1929 and 1932 was about 15% or so. You're saying I'm the one being hyperbolic for calling a drop of twice that size in three months a total free fall?
I apologize I forgot about Jeff Bezos and your local taco guy. I'll try to be more optimistic, like you are doing here, by predicting an instant drop of economic activity to twice the severity of the Great Depression.
And sure I'll take your bait on specifics anyways. I think we should pick policies just restrictive enough to keep hospitalizations below system capacity and no more. There really isn't any other reasonable choice, the current policy is just delaying the inevitable for no clear reason and without any specific vision of what success looks like.
You realize that if we have the same number of cases, and deaths, but with 3-4x the economic destruction, that's a spectacular policy failure right?
> The drop in GDP between 1929 and 1932 was about 15% or so.
I could be entirely wrong, but I just wonder whether GDP is a good measure or not for this situation. Think about childcare - it's not that children are not being cared for: in fact, they might be getting more attention from their parents or other family members. Yes, the daycare is shut down and not making money, but the work is still performed. Similar to restaurants vs. food made at home.
I wonder if the loss of non-essential businesses is as detrimental to our economy as the loss of essential businesses. During the Depression, we were losing essential businesses like farms and then on top of that we had a dust bowl. The economy feels very squishy - as in, we're able to layoff and furlough an amazing percentage and people still get the basics like food, water, and shelter, and we still have luxury goods: Apple is still releasing new iPhones even though they're made in China, we still have craft beer flowing, and we can get tacos.
Tied into this, though, is that we do have to keep money flowing not through labor, since that's illegal for a lot of folks, but start figuring out better unemployment insurance and small business aid.
Ease up by returning to normal economic activities, but with mandatory masks and gloves for most workers and consumers, while strongly encouraging social distancing.
My current belief, based on experiences reported in other countries, is that this would be enough. There's not much evidence that total physical lockdown is necessary for everyone regardless of their level of vulnerability.
I'm painfully aware, which is why I asked the question. Who would you like to see back to work, and are you certain they're not already on the list of essential positions?
If many people get very sick simultaneously, they would not only overwhelm hospitals, they would also inflict a disorderly, involuntary shutdown of large swaths of the economy, driven by fear -- instead of the orderly, voluntary shutdown we have at present, driven by government mandate.
We all want to avoid a disorderly shutdown driven by fear.
The current so-called shutdown (at least where I live) seems to be mostly voluntary. People are out and about horsing around all the time. There's no difference in traffic before and after on my street. It's pretty much being ignored by many people, and there's no visible enforcement. It seems more like a stay-at-home suggestion than an order.
Here in BC we don't have such restrictive conditions, and yet we still have very few cases. Vancouver has about 76% of the population of SF, but has half the number of cases. Restricting people to be at home has no benefit, no logic behind it, but has significant repercussions on mental health.
My understanding is that the Vancouver lockdown is largely identical to the California one, no? What is open there that isn't in CA? I know restaurants, theaters, large gatherings, etc... are all closed, which is the economic activity most of the "reopen" people are concerned about.
Edit to note: two responses "disagreeing" with me by pointing out that the BC lockdown is effectively the same thing as the California one from the perspective of economic impact. This is why I asked the question! People are being fooled into arguing with a strawman idea of "lockdown" that isn't what is actually implemented.
First, it's not a Vancouver lockdown (it's a BC thing), nor is it really a lockdown at all. Nobody is legally required to stay at home except for people who are under a specified health order. Here are the restrictions on life that are most commonly noticed:
1. Restaurants are closed except for take-out and delivery.
2. Personal services businesses are closed.
3. Large gatherings of all kinds are banned.
4. Schools are closed.
You can still go to your office if you wish to, so long as social distancing rules can be respected (staying 2m apart). This being said, the vast majority of businesses that can have their employees work remotely are doing so, simply out of a concern for their health and wellbeing. If you have to have employees in your workplace, then there are guidelines for making it as safe as possible.
There is also extensive testing. Anyone with symptoms can be tested promptly.
FWIW I'm not familiar with CA specifically, but that sounds like the same kind of lockdown we have here in NY.
Offices are voluntarily closed, as far as I can tell, not by fiat. While you're only supposed to be working at an office if you're an essential worker, the definition is somewhat loose.
No. We are allowed to drive. All workplaces are open except for places like restaurants, personal service businesses, gyms and theatres. Other businesses just have to ensure distancing.
We're allowed to drive in California too - its supposed be for "essential" travel only, but that is pretty broad. I'd estimate in the Bay Area, traffic is only down by 50% or so (though certain commute routes are more dramatically impacted).
"Everyone is required to stay home except to get food, care for a relative or friend, get necessary health care, or go to an essential job... If you need to get into a car or on public transportation to go for a walk or run, you’re going too far."
Correct. Driving somewhere doesnt increase risk, any more than walking near your home. In a large city you are probably better driving outside the city.
The lockdown restrictions are a faith based policy, not evidence based. There is no hard evidence that they will reduce total deaths over the full span of the pandemic.
That (1) driving is a pre-cursor to contact with others and (2) driving requires contact with others (gassing up, toll booths, parking attendants, snacks, LE and so on) and (3) driving could lead to accidents which might in turn lead to you ending up in the ER or requiring ambulance transport.
Walking or driving can be a precursor to contact, but as mentioned in my previous comment, if you live in a large city it is difficult to physically distance yourself when walking outside. You are probably better driving to a more remote location for exercise.
Generally there is sufficient distance from other people when gassing up, so that seems like a very low risk for a short period of time, compared to walking in a city.
You are also at risk of requiring ambulance transport if you do DIY work at home. So best just sit in a dark room because you don't want electricity workers to have to go to work, or Netflix employees to have to go into work, etc.
If you think a pandemic is the time to start major DIY projects then you really don't get it. You're not alone in that, but that doesn't make it smart or right.
If we expect a roughly fixed number of people to eventually need hospitalization, then underutilizing hospital capacity is a waste of very expensive shutdown time.
The shutdown is preventing quite a bit of sickness, disability and death from occurring during the course of the shutdown. If we could indeed maintain a shutdown forever, and if that would reduce the total amount of sickness, death, etc, then maybe it follows that an indefinite shutdown would have value to weigh against the cost. But those are some seriously questionable assumptions. What actually seems to be happening is that we are delaying people getting sick, and the value of that is not self-evident.
I am suspicious that much of the COVID-19 response is based on pretending that it is a severe pandemic flu with a comparable fatality rate. With a flu, shutting the world down until summer or until a new flu vaccine can be mass produced has clear value. But COVID-19 is not the flu.
The problem I see with that statement is that it's difficult, if not impossible to falsify.
Hospitals are nowhere near being overwhelmed, in general, which means that they have some capacity to handle an outbreak if we lift restrictions gradually. I know people who work at hospitals in places like LA, and they've reported that activity is relatively slow. (of course in part because fewer people are going to the ER for other issues)
Lives are being ruined by furthering a draconian lockdown. I know several people who have not only been laid off, but had their businesses destroyed and their dreams crushed. Someone in my neighborhood spent their life savings on starting a gourmet burgers and brews joint next to a movie theater, which would have undoubtedly succeeded in normal conditions. They're getting very few curbside orders because they opened after the pandemic started and nobody is familiar with the brand. They're almost certainly screwed, especially if some semblance of foot traffic doesn't begin coming back in the next month.
I, too, was in the early stage of starting a brick and mortar business before the lockdown. Fortunately, I hadn't opened up anywhere yet. Because my business relied on the existence of gyms, I would have been massively screwed. If there is a god, I'll thank him now for not putting me through the ordeal of owing tens of thousands of dollars to the bank. Now I'm not even going to bother opening up because there may not be any appreciable business in the next year or so, which also means people whom I would have employed have to look elsewhere and may be out of work.
Low hospital utilization seems to have become our only metric for success. I think that's crap, especially now that it's coming out that way more people have had this virus than the numbers suggested.
We can put on masks, wash our hands, and all that, but this idea that "the new normal" is to have little to no proximity with other human beings is demoralizing and wrong. Life isn't just about staying alive.
EDIT: To bring up anecdotes is not a fallacy, and I won't apologize for it.
Some ignorant boob happened to bring up NYC, and their comment to mine got flagged, but I still want to reply to that point.
You can't focus in on a particular city and then claim that, without draconian intervention, that NYC will be coming to a neighborhood near you. It's more complicated than that, and the more data we are getting, the more it's looking like we could begin to take measures to ease the restrictions in a reasonable way in parts of the world where it makes sense. But people like to point at the raw numbers rather than looking at the science or the per-capita numbers.
By using the logic of "but look at NYC!", we should keep the entire world closed until every city on the planet has no more cases, which is highly improbable and destructive.
+ CO2-increased houses make people much less clever,
+ Demotivation/decrease of testosterone makes people durably less productive, further hampering our ability maintain the little flow of goods that’s left.
We are setting up ourselves for a much more deadly future.
Exercise hasn't been banned, so unless you absolutely can not exercise without a full gym, there shouldn't be any reason to think people will be gaining weight, or having decreased testosterone. Even if you don't want to leave the house, you can still do things like Yoga, lift weights, or any number of other physical activities that need little or no equipment.
I'm not sure what the concern about CO2 is - at least in the Bay Area, we're in prime keep-the-windows-open-all-day weather. And the status quo would be working in offices or other buildings that tend to not even have openable windows, so even if the weather wasn't nice, indoor CO2 shouldn't be a concern.
That may be true, but that isn't going to change human behavior. Encouraging people to continuing to work out at home is a good thing, but most people are demoralized. Fewer people are going to exercise because there's nothing to do, nobody to see, and not much to look forward to for the next year. I know my fitness has decreased due to demoralization. Sure, I can exercise, but it's hard to find reasons to exercise beyond mere health. Most people also want to be fit because they want to look good, but during the pandemic, looking good for whom? Toss unemployment income and "survival" junk food into the mix, and you've got a population that is probably overall less healthy.
I'm on board with keeping up the exercise, by the way. It's just that the reality is that people aren't going to come out of this more healthy because their motivation has been crushed.
>The problem I see with that statement is that it's difficult, if not impossible to falsify.
All you have to do is take a look at hospitals in NYC to know how wrong you are and right the person you responded to is.
>Someone in my neighborhood spent their life savings on starting a gourmet burgers and brews joint
Holy shit won't someone please think of the gastropubs. This is why I'll never believe this is a good faith concern for the people that really need our concern right now: no one ever says "I know a delivery driver" or "I know a busboy" or "I know a janitor" that needs help. It's always some lifestyle business owner that we should be weeping for in these outcries.
of course i would. would you like to setup a call so i can tell you to your face in real life how absolutely morally repugnant and completely facile your ideas are?
i don't care i'm not a politician. people like you get away with spouting nonsense because no one ever shames them for it (they've always gotten the benefit of the doubt about their intelligence). i'm a firm believer in shaming people for their stupidity when it affects others. you have zero stake in this mr webdev and you should at least be forced to ante up your ego. so i don't care if you're persuaded, only that next time you'll think twice about opening your mouth because you expect everyone will just politely disagree with you.
We were on an exponential growth path before. Now we’re not. It’s impossible to prove that an intervention made things not happen, but this is the predicted outcome.
I don't know about San Francsico, but, in much of the less population dense US West, the deaths from denial of so-called "non-critical" procedures are getting out of control, and hospitals and medical facilities are losing way too many employees.
People should remember that the mortality rate for COVID-19 is under 3% _with_ medical care. If it isn’t available the mortality rate goes way up to around 20%.
Wuhan hit about 17% in the early days when their hospitals were overloaded. I though that was common knowledge? I also thought it was common knowledge that about 1 in 5 symptomatic cases require medical care.
The cdc has revised their estimates down in wuhan from 17% to 12%, and hospitalization rates have also gone down as testing has improved over the last few weeks. On the flip side there is mounting evidence that many COVID-19 deaths are not being counted.
Continuing a lockdown of this severity makes no sense. San Francisco has only had 22 Covid deaths. A city the size of SF would be expected to see 5x as many cancer deaths as that in a normal month [1] and 7x as many heart disease deaths [2]. Instead, we're maintaining a policy that discourages people from seeking preventative treatment for these diseases on the basis that we don't want them contracting a less deadly disease.
The lockdown has proven to be excessive. The doomsday predictions have not come to pass, and we're entering a time of year that is known to be correlated with reduced rates of viral spread (Flu infection rates are 30x higher in the winter than the summer [3]). We need to get people back to work now. Social distancing should still be maintained where feasible but a blanket lockdown will cause way more harm than good.
> The lockdown has proven to be excessive. The doomsday predictions have not come to pass
Alternate interpretation: the lockdown worked.
I fully agree that continual lockdown without a concrete plan for what its achievable goals are, and how and when we'll reopen is excessive. Some kind of targeted, data-driven reopening in stages is the right way to be headed.
This reminds me of a quote going around a few weeks ago: "If we have done a good job, everyone will say we over-reacted."
As a counter point, NYC did _not_ do a good job and at it's peak COVID-19 killed more people than heart disease and cancer during the month of March [1].
> A city the size of SF would be expected to see 5x as many cancer deaths as that in a normal month [1] and 7x as many heart disease deaths
This comparison is irrelevant. Cancer and heart disease aren't contagious and don't spread exponentially.
Let's say there were 0 deaths from Covid-19 because there are enough beds and they got lucky enough to save everyone. Would you say that an infinite number of more people die from lightning strikes?
> The lockdown has proven to be excessive.
Because not enough people are dying? I honestly don't understand your logic.
I'm starting to see these arguments take startling similarity with the anti-vaccine arguments.
Which is that vaccines aren't necessary because people are no longer dying from said vaccinated diseases. Perhaps it's important to consider that one of the reasons why the doomsday predictions haven't came true is because places took action early.
We in fact know very little about the consequences of serious C19 infections in people under 50, and people in their 40s apparently make up a substantial cohort of ICU C19 patients. We also don't know the long-term health implications of a severe C19 case, and there's some evidence to suggest permanent lung damage is one possible outcome. And, even if we didn't know any of those things, avoiding the deaths of people over the age of 50 and the deaths of people of all ages with asthma and hypertension would still be a worthy reason to hit the brakes while we learn more.
We don’t know enough so let’s stop the economy while we find out? That is not typically how we do things, because it’s not a rational response. For example, we didn’t know whether holding a mobile phone close to our ear for extended periods of time leads to serious health issues, and there was suspicion that it does. But we didn’t prohibit it — we let people decide for themselves, and it does seem the risk was lower than suspected.
What’s happening now seems more like a knee-jerk reaction than the result of a cost-benefit analysis.
+1. This argument about not knowing long term effects of COVID-19, and hence we have to keep the economy shut down indefinitely makes no sense at all. Making masks mandatory in public, keeping people at risk at home and starting to open up the economy sounds like a more sound strategy.
Many people die in traffic accidents every day, but we don’t ban cars. Everything we do involves some risk. There needs to be a rational discussion on how much lock down is appropriate. We need to look at other countries like Sweden and Austria and learn from them. We need to look at the real costs of a depression. What we have now is “People are dying so let’s lock down everything”.
You can mitigate the risk of dying in a traffic accident unilaterally in ways you can't with a virus, and C19 is probably already killing more people than car accidents by a significant margin.
Sure you don't wear seatbelts and install airbags to mitigate the risk of COVID-19, but the point is that you can take measures to reduce the risk of contracting the virus to a socially acceptable level and not have to destroy people's livelihoods. We have after all not waited for the perfectly safe car before allowing millions of cars on the road. The lockdown in its current form seems more like waiting for the perfectly safe car.
At what cost? When do you factor in the additional deaths and other consequences from suicides, domestic violence, increased substance abuse, and so on? There are two sides to the equation.
There is dated data (from 1981) showing a 37,000 increase in deaths for each percentage-point rise in the unemployment rate. It comes from a book called “Corporate Flight: The Causes and Consequences of Economic Dislocation” by Barry Bluestone, Bennett Harrison and Lawrence Baker.
From the article citation below:
> Here’s the paragraph from Thomas’ book that applies: “According to one study [the one by Bluestone et al.] a 1 percent increase in the unemployment rate will be associated with 37,000 deaths [including 20,000 heart attacks], 920 suicides, 650 homicides, 4,000 state mental hospital admissions and 3,300 state prison admissions.”
The data is stale, for sure, but the correlation (economic downturn->increase in deaths) is arguably proven.
(I was unable to find an online version of the book to link to in Google Books or openlibrary.org; I bought the book used from Amazon, it's headed to the Internet Archive for scanning).
Then what's happening right now is a refutation of that data, right? Because we have sky-high unemployment and nothing resembling those numbers. It's almost as if unemployment in ordinary circumstances is not the same as unemployment caused by a discrete, universally-applicable crisis.
I think the "harm from unemployment will swamp harm from C19" argument will get stronger the longer lockdown lasts, but that the ~month we've had widespread lockdown orders is not close to long enough to make the argument without clear data. We have strong evidence that explosive C19 case growth kills lots of people; that's a hard data point to overcome.
If you want to be frustrated with the unbounded nature of the crisis, I think the right place to focus that anger is on testing; in Illinois, we have something like a 22% positive rate on PCR testing, suggesting we're not testing nearly enough people.
I drove passed a testing center in Aurora at the Premium Outlet Mall (I-88 & Farnsworth) twice this weekend, both Saturday and Sunday morning. They opened at 8am each day, and had reached capacity shortly after. I agree that testing efforts deserve the ire of the populace.
There's always "other consequences" you can point to for whatever policy. What about the upside that many can now work from home with flexible hours, and avoid the 996-ICU workweek.
Long term health implications have nothing to do with the lockdowns, and extending them has no impact on those theoretical boogey-men.
Lockdowns were intended to 'flatten the curve' so that hospitals aren't overwhelmed. The same number of people will get sick but over a longer period of time. Keeping the lockdowns in full effect will only ensure that those who get disproportionately sick are the ones in critical services and healthcare.
Choosing to violate people's constitutional rights based on hypothetical long term implications is also extremely disconcerting.
That's a talking point, not an argument. In reality the state governments have broad powers, stemming back to jurisprudence from the time of the framers (cases involving these powers were heard by John Marshal), to employ police powers in the service of quarantines, and those powers were further spelled out by statute as recently as the 2000s in the wake of 9/11. None of those powers are constrained by any notion of "flattening the curve", a "flattened curve" isn't a permanent state, and there are rational goals to quarantines beyond keeping the hospitals occupied at an optimal level.
> there are rational goals to quarantines beyond keeping the hospitals occupied at an optimal level
None of the counties in the San Francisco Bay Area have been willing to outline any specific goals, nor has our Governor. If you can point me to anything more specific from the above than 'if we only save one life', I'd be shocked.
What's your point? Is there a statute you're thinking of that requires San Francisco to spell out specifically what their goals are? You said upthread that the lockdown is a violation of people's constitutional rights, but it seems clear that it isn't, at least not in our jurisprudence. You can find legal scholars debating the constitutionality of quarantine, but only in the context of hypothetical orders that haven't been issued by any state yet that would imprison people in their homes (the way China apparently did). If you don't even have the broad strokes of this right, it seems fair to ask for a citation here.
I require San Francisco to spell out what their goals are! I fundamentally reject the idea that it's our duty as citizens to shut up and do whatever London Breed thinks is best. If she's not willing to explain why these emergency restrictions are necessary and how we'll know when they aren't necessary, we shouldn't comply.
Yes, even if this isn't required by the letter of the law, it certainly does seem to be required by the spirit of US law that the people are not mere subjects to be ordered around. At least in spirit, they deserve to be informed, so that they can make an informed decision about whether they believe their representatives are behaving reasonably. And if they don't agree, they can vote them out, or exercise their free speech rights to voice their dissatisfaction.
Is there a statute somewhere that requires London Breed to spell anything out to your satisfaction? I don't know what California's emergency management laws look like; maybe you're right.
Does there have to be a statute to advocate for a rational, numerical based approach to public policy?
You're a super smart, analytical guy. You don't see any problem with imposing extremely restrictive rules on a population of millions without even a basic attempt to quantify what your desired outcome is?
Why do you want this to be a simple problem? It isn't a simple problem, not by a long shot and erring on the side of caution seems to be the right way to play this because you are at most 4 weeks away from a serious disaster if you fuck it up. The fact that SF does ok is a result of the shelter-in-place order, without it SF would look like NYC or worse.
Nobody said it was going to be simple. I'm just advocating that it not be completely and totally lacking in stated goals when it's such a severe policy intervention.
Those goals could be complex, or detailed, or multivariate, or subject to contingencies and caveats. But they can't be non-existent and they can't be secret. This is a democracy.
> The fact that SF does ok is a result of the shelter-in-place order, without it SF would look like NYC or worse.
Your sentence here is making a quantitative assessment that the result is worse than NYC, without stating the metric you're using to arrive at that assessment, or hinting at the means by which it was arrived at. It's just "worse".
That's fine for an forum comment. But it's a disaster as a government policy almost six weeks into this crisis.
What's being criticized here is the parent story, which is a press release by the actual government, and appears to make no mention of the criteria used to arrive at this drastic and staggeringly expensive policy decision, and contains nary a hint of what metrics they'll use to evaluate it, or critically, determine if the schedule should be delayed or accelerated. That's crazy.
It sounds to me as though you do not trust your leaders to have your best interests at heart.
The idea that everybody will go and pick apart the underlying data to support their favorite little theories may have something to do with the decision to keep the inputs confidential.
You get one chance every so many years to vote in a government that you trust, you're going to have to accept that.
> The same number of people will get sick but over a longer period of time.
Fewer people get sick for two reasons.
Flattening the curve reduces the amount of epidemic overshoot. People assume you reach herd immunity levels and the epidemic then dies out. Reality you overshoot herd immunity.
At some point you can reestablish contact tracing and isolation. That by itself reduces the required level of immunity and containment needed to keep the infection in check. Except for a few countries we don't have that now.
My bet at this point is within a few months. Rapid RNA tests will start being produced in large numbers. Synthetic anti-bodies for covid19 will become available. Contact tracing and isolation containment will be reestablished. Rapid RNA tests make contact tracing possible at scale. Antibody therapy increases the effectiveness of contact tracing. Basically you test everyone with symptoms. You then dose all their contacts with anti-SARS-COV2 antibodies.
What if it doesn't? What if a few months pass, and we're at the same spot we are now, except we're all a few months older and poorer?
My jurisdiction is already testing everyone with symptoms with only about half of their current testing capacity, and still has no plan to move forward.
> Meanwhile, data is coming out to show that coronavirus has a very low fatality risk to anyone under the age of 50, and to anyone without pre-existing health conditions.
34% of America is aged 50 and over[1]. Almost 40% of America is obese[2], which is a risk factor for COVID-19 complications[3].
> A blanket shutdown does not make any sense when the vulnerable demographic has been clearly identified.
When the "vulnerable demographic" is forty percent of the population, a blanket shutdown makes a lot more sense. We cannot simply consign four out of ten people to severe illness, unknown long-term complications, and/or death.
Personal responsibility must enter the equation; otherwise, you're consigning those of us who have made good decisions about our health to pay the price for those who haven't.
Why does my life, as someone who has made 'good decisions', matter more than someone's who has made 'bad decisions'. Especially when many of those 'bad decisions', like obesity, are products of socioeconomic environmental risk factors. This seems like a very privileged perspective which probably isn't very productive in managing a diverse society in times of crisis.
Solidarity must enter the equation because if you don't take care of those who are vulnerable, the economy will tank worse than it already has. People dying is expensive, and this many people dying is a lot more expensive than the cost of keeping things officially shut down.
Why is nobody focusing on Sweden's COVID numbers? Sweden didn't institute city-wide shutdown measures. Yet, there hospitals are not overwhelmed. And, their COVID case counts and death counts are plateauing.
> How is it moral to order people to shelter in place when their risk of death is 0.01% for 18-45 year olds
The data from your second source indicates that the case fatality rate in New York for 18-45 yr olds is 0.833% (14 deaths in 1705 confirmed cases). Where are you getting 0.01% from?
I don't see how the math for that works out unless literally everyone in NYC is already infected.
0.1% of the population of New York City has already died from Covid. The only way to get the CFR much lower is if virtually everyone is an asymptomatic carrier.
Food for thought - if say 70% of cases are asymptomatic or mild (and therefore they don't get tested), then NYC's CFR already drops to 0.2% for the bucket you are referring to.
In fact that's the number reported for that demographic from Wuhan data way back in January, so it wouldn't surprise anyone. It's still 20x higher than the one quoted upthread.
While I disagree with a bunch of the reasoning you use above, I agree that blanket lockdowns aren’t needed anymore.
Seattle seems to be getting out and about now, but people are being super careful and everyone’s giving each other tons of space. I don’t see why that shouldn’t apply in other places too. In a lot of ways the shelter in place guidance is a mental drain more than a real policy in my mind at this stage.
Our society includes people who are over 50 - how do ensure that YOU do not transmit coronavirus to them if you are under 50 and asymptomatic? I know a lot of people are pretty upset but it's not just about YOU. It's about everyone you come in contact with.
Just a thought, but it seems like there can be a middle ground where people belonging to certain risk groups (age, preexisting conditions, etc) are encouraged to take stronger shelter in place measures, and in exchange are granted larger amounts of financial aid to compensate.
People not belonging to risk groups can resume working, still taking extra precautions to prevent transmission. The economy can gradually reopen while also slowly building up herd immunity among the least vulnerable population. It seems unsustainable to have an indefinite blanket lockdown, but I’m very open to changing my mind on this.
I'd truly love to hear a good counterargument to this. I've argued much the same thing only to have the same opposing talking points restated verbatim.
You and the parent posters are assuming that everyone lives on their own and that younger people don't live with or take care of older people. Once things open up, employers will expect younger employees to show up. Couple that with asymptomatic transmission, how do you practice social distancing in a closed home?
The purpose of the lockdown is not to prevent everyone from getting the disease, or to hide in our homes until it magically goes away. The stated purpose of the lockdown was to 'flatten the curve'.
Don't go moving goalposts on us all now that we've flattened the curve, especially when we're talking about people's constitutional rights.
Moving the goalposts was always the idea. That's what the governor here in WA did, and said as much.
I, personally, am livid that the construction site right outside my bedroom window is now allowed to make ungodly amounts of noise for 15 hours a day and I have nowhere to go. This is insane.
Lockdowns have a tremendous cost in mental health. There's a point at which the toll is simply too high. We're not there yet, but it's not far. And waiting until "the data shows it" through elevated suicide rate is... not how I want us to play this, as a society.
Moving the goalposts could probably be a confusing bit of terminology here. OP means that the original intention was “lock down so that we don’t run out of ICU beds”, and now it is “lock down until there’s a vaccine”. The end condition is being changed every time we get close to it.
I agree that there are a lot of problems with continuing the lockdown as it currently stands. However, the phrase "now that we've flattened the curve" could be interpreted to imply the curve can't quickly become unflattened, which would be wrong.
The only thing that is going to keep the curve flat (this is kind of a mind-numbing terminology) is human behavior. Exponential growth is still a thing, and we aren't anywhere near achieving herd immunity.
(a physician friend mentioned the other day that we're not truly certain yet that COVID 19 sufferers cannot be reinfected, although that's the popular assumption. So there's also that)
Out of curiosity because I have little to no knowledge of immunology: what do you think that means if someone that already had the disease can be reinfected? Does that have any implication on the efficacy of a vaccine?
The physician I talked to was basically trying to rain on my parade when I said "hey, it will be great when there's a vaccine and we can all go back to normal." Maybe, maybe not.
I don't know that much about it, but sometimes people infected with a coronavirus can get sick again, not as ill as they were previously, but contagious. [1] COVID 19 hasn't been analyzed well enough, long enough to say for certain.
There were some scary stories early on, a month or two ago, about people becoming reinfected with full blown cases of COVID 19, but they really felt more like uncertain anecdotes. I strongly suspect the immunologists will know a lot more about this in just a few weeks. Researchers are already giving people test vaccines and sending them out into the world.
In a nasty - hypothetical - reality where people regularly get reinfected: things do not go back to normal, and we have to figure a lot of difficult social stuff out.
Unfortunately, yes. Consider the common cold: yes, it does mutate fast, but the other big barrier to producing a vaccine is that immunity to it doesn't last very long at all. So if COVID-19 immunity truly doesn't last long, that's a problem.
I doubt this is likely to be the case, though. Antibodies to SARS seemed to have long lifetimes (several years), and COVID is likely to be similar. It is certainly possible that for some people, immunity fades much faster for reasons specific to that person, and that may be what is being picked up in these reports.
It is also possible it's just shoddy lab work. There has been a ton of that going around lately, and it's not just caused by pressure from the situation. Not all scientists are equally competent....
(Disclaimer: my knowledge of immunology is likely little better than yours, but I did at least used to be a Real Scientist in a different field.)
The reason that antibodies to SARS have long lifetimes is because it is a much worse hit than COVID-19 in most cases, you can take the CFR as proof of that. Harder hit to the immune system but you survive: immunity will last longer is a good rule of thumb.
The situation is rapidly developing. Our knowledge is constantly growing and will continue to do so. Under these circumstances, I don't think moving the goalposts is avoidable. Nobody is hoping for magic: they are waiting till it's safe to go outside. Perhaps a vaccine will make that a reality in...a couple years? Regardless of what the government does, I say, prepare for a long haul.
On the one hand there is a tremendous amount of real damage being done by everyone sheltering in place. On the other hand it's not the government's orders that are the direct cause, so much as the virus itself. We are in a global pandemic. It is unprecedented. Telling everyone to go outside again is not going to magically make it happen.
Can you imagine re-opening schools right now? Summer camps? It would be sheer carnage, and those who do want to protect themselves will be less able to do so. It would just shift the pain points around, and cause a lot of deaths right away. Would that be worse than it is right now? Probably. Would it be worse than another six months of sheltering in place? Nobody knows!
I am over 50 and asthmatic - if I feel that I am in danger I am free to self-quarantine. There is no need to impinge on everyone else's freedoms to ensure my safety - I am a big boy and able to take care of my own health decisions.
You can only choose to self isolate if you have the means to give up income. Needing to come up with necessary expenses like food and utilities would be understandable, but the largest bill is rent which is a mostly product of our financial system rather than an intrinsic requirement of existence.
I could be in favor of lifting shutdown orders if there were a corresponding federal push to either halt such payments or reimburse people (federal is where the bulk of the money is distributed/printed). But without that, it's disingenuous to frame the situation as some kind of choice, when it's really the same unempathetic turning of the screws on the marginalized.
People aren't going to be able to pay their bills regardless of whether they're locked down by mandate or by choice. However, if we allow the low-risk population to continue working, they will generate tax revenue that can be used to provide for the high-risk population. From that perspective, lifting the lockdown for low-risk persons is strictly better for the high-risk population than maintaining a blanket lockdown.
The difference is that with a shutdown mandate, many people are in the same boat, which necessitates a solution. It's not uniform ("essential" and remote workers), but it's better than putting even more people in the position of having to choose their health or eventual homelessness. Especially say, to just work in nearly-empty movie theaters.
The tax revenue is a red herring. Print the money, as was quickly done for the corporate bond bailout. Or better yet, do the sustainable thing and just suspend rent payments and mortgage interest, so that the debt black hole actually unwinds a bit.
There seems to a ton of people with long term organ damage from this thing. Brushing it aside as a non event for everyone else is dangerously misinformed.
> There seems to a ton of people with long term organ damage from this thing
Are there? I've seen only a few isolated anecdotes. In any illness affecting tens of thousands, there will be a few who experience particularly severe complications. It's not useful to portray these complicated and severe outliers as being typical. Right now, the data show that the vast majority of people who contract this virus fight it off without experiencing any symptoms whatsoever and suffer no long-term damage at all, which is exactly what you'd expect from a typical virus infection.
People keep claiming that this virus has exotic and dangerous features atypical of coronaviruses and viruses in general: I've seen everything from claims of immediate reinfection to 30-day incubation periods to long-term gonad damage. None of these claims has been substantiated on the basis of anything but isolated (and frequently unsourced) anecdotes, and a very strong Bayesian prior should be that this virus works like any other and doesn't actually do these random and exotic things.
There seems to be a contingent of very online people who want to sow as much fear and anxiety over this thing as possible, even if it means presenting a warped view of the data. We should reject this endeavor.
People are irrationally terrified by COVID. There is of course a rational level of respect we should have for it, but people are TERRIFIED. That's why you are getting downvoted (and I will too probably).
Thankfully, you appear to be overwhelmingly outvoted in this "let's set up a peeing section for the swimming pool" position. Lockdown measures and the activist governors pursuing them are, for the moment, overwhelmingly popular --- the population as a whole is strongly more concerned that lockdowns will end too early, and strongly more worried that they will suffer health consequences from C19 than that they'll suffer economic consequences from lockdown.
Sadly you seem to be of the opinion that we can cower in our homes until the disease magically goes away. That's not the way this works - it doesn't just go away.
I'm really disturbed by the number of people who seem to be perfectly happy moving the goalposts for these lockdowns as long as they're politically popular. Here's a hint - freedom and constitutional rights weren't intended to be politically popular (or particularly safe) as the popular opinions don't need protection.
This isn't responsive to anything I'm saying; it merely repeats points you've made earlier more emotively.
I think you're going to find that the message board logic of "a-ha, I read a tweet that says the goal of lockdown is flattening the curve; now that curves may be flattening lockdown has to end" isn't going to get you very far in the real world.
It actually does mean something, which is that freedom is not unlimited. Your freedom of action ends at the point where it harms someone else. Classically, "your right to throw your fist ends at my face." It's the same reason (legally) you can't point a firearm at me.
What we have here is the problem that merely by breathing around someone, you can cause them harm. Unfortunately we lack the ability to determine whether or not you will, but given the contagiousness of this disease if you are infected (or become infected) it is quite likely.
I am over 50 and have immediate family members in high risk categories.
I was onboard with what was clearly a panic response by policymakers since the testing and the healthcare infrastructure was not in place. To the best of my understanding, there has been no movement from this initial panic to working through strategies that transition from massive shutdown to identifying and isolating the sick or those they have come into contact with. If we were moving forward on that front, I'd still be supportive of buying some time... I see none of that.
I see dull minded politicians and bureaucrats doing what they got away with early.
This has to stop and endless hiding in a hole waiting for some miracle vaccine or the disease to just go away of it's own accord simply is not acceptable.
Where do you get this figure? Your first link shows 14 deaths per 100,000 in that age range, or 0.014%, but that is for the entire population, not just people who have had the virus. The same data set reports 1705 cases in that age range. 14 deaths out of 1705 cases is an 0.82% fatality rate.
Of course, that 0.82% figure, reflecting only confirmed cases, is inflated. But conversely, some of those 1705 afflicted 18-45 year olds may still succumb to the virus. The true IFR in this age range in this region _might_ be closer to 0.1% than 0.82%. But 0.01% is just wrong.
I think this is a lot like finishing your full 7 day medication treatment, even though you feel fine on day 3.
That said, I don't know when and how the right way to wind down is, and I don't think anyone else does either. I'm glad we're doing this in a decentralized way over 50 states, so many different strategies can be tried.
I would also add that we who can WFH with full wages do well to remember millions of already less well off people have been left without income and life structure, and they're not just complaining because they're spoiled children!
When you take a 7 day course of antibiotics, you are reducing your bacterial load to a level at which it is highly unlikely to bounce back from zero and, critically, the chance that it bounces back and selects for resistant strains is comfortably low.
No one seriously expects any length of shutdown in the US to reduce the case count enough to eliminate COVID-19. Worse, even if we reduce the case count to an unnoticeably low number, we’ve made essentially no progress
toward a suppression strategy that will detect and control new cases to avoid another shutdown.
I was more saying that you probably need to wait longer than it seems you should. In part because we're dealing with exponential growth.
> Worse, even if we reduce the case count to an unnoticeably low number, we’ve made essentially no progress toward a suppression strategy that will detect and control new cases to avoid another shutdown.
Another reason to postpone everyone getting infected is that the longer that waits, the better treatments we'll have for the sick.
Funny that this is exactly the same narrative as here in the UK. Initially it was about flattening the curve for healthcare capacity, now we are in some weird holding pattern where the goal is becoming increasingly vague.
The second link is death per 100,000 people (not death of confirmed cases), that, for 18-45, is 14.21 per 100,000 (0.014%). There are confirmed cases of 1705.26 per 100,000 for 18-45. Thus, the death for 18-45 over confirmed cases is 0.83%, much higher than flu for 18-49, which is 0.02%: https://www.cdc.gov/flu/about/burden/2018-2019.html. Noted that the new antibody tests showed much higher cases than the confirmed cases. But the 0.01% number you cited is wrong. Please fix.
The "very low fatality risk" thing only applies to people who can get proper treatment for the disease. If healthcare resources get overwhelmed, the fatality risk will get a lot higher, for the younger population also.
> The initial premise of the "flatten the curve" memes was to avoid overwhelming hospitals.
I don't think it was a 'meme' - if you're thinking it was just something on Facebook or something like that. It was and still is a government goal informing their policy.
Setting aside Dawkins, and looking beyond image macros, it seems to me that the meaning of 'meme', in it's common usage, can encompass the meanings of "message", "claim", "idea" and more. It's not necessarily dismissive, and can sometimes emphasize the simplicity of structure or frequency of use.
What's different now vs before the lockdown started regarding flattening the curve? R0 is a little under 1 right now, but what will it be when most things reopen?
The goal of the lockdown is to keep R0 under 1 until we have measures in place to permanently mitigate the spread [1]. This means lots of testing and contact tracing, which is not even possible right now with case numbers being as big as they are.
Reopening right now would just get us back to #flattenthecurve in a matter of 4 weeks.
> There is no risk posed to the majority of the population from covid-19
There is risk to everybody, it's just lower for some. There's enough evidence of permanent damage inflicted on organs and other gnarly details that I (34M) will be absolutely careful not to get this disease. [2]
Multiple counties have already confirmed they are contact tracing every case. The Bay Area has a lower per capita daily case rate than Germany who is opening schools. This should be manageable.
Now we should be slightly reopening and targeting an Rt near 1, and driving towards population-based immunity.
We had looser controls from mid-March to the beginning of April. They were evidently effective. Why do we need to stay in a regime of stricter controls-- mayhaps we can loosen a little from ehre and see what happens?
Plenty of jurisdictions have less restrictive orders than the SF Bay Area, and are showing declining case counts.
In New Zealand, South Korea and Australia coronaplague is on the way out thanks to testing and contact tracing. Why can't the US muster the political will to do the same?
We are already seeing the damage because a number of meatpacking plants had to go off-line when a substantial part of their workforce was ill and could not report to work, yet many citizens advocate for even lighter restrictions. Nothing of this makes any sense.
>In New Zealand, South Korea and Australia coronaplague is on the way out thanks to testing and contact tracing. Why can't the US muster the political will to do the same?
When it comes to complete elimination, you leave out the most important ingredient: all three countries have fantastic border control, thanks to geography in two cases, and an extremist neighbor in the third.
Compared to some Western European countries, the US are looking pitiful. Italy went from 5000 cases/day in early April to 2000 now and Germany from 7000 cases/day to 1500 now. The US continues with 25000 new cases every day and no downward trajectory in sight. This is community transmission, not imported cases.
This is in no way relevant to my point. You brought up three countries that have nearly eliminated the virus from their land, while overlooking the single most important prerequisite in all three cases.
Edit: In other words, we can strive to reduce community transmission, but achieving the specific results found in the three you mentioned would also require a radical change in how we handle our borders.
No it wouldn't. You ignored his point entirely, which is that even if we did manage to further lock down our borders, it does nothing to stop community transmissions. Those countries you listed weren't able to control the virus through strong border control, they did so through strong controls over community transmission.
Which should've been obvious, considering the initial transmissions in South Korea came from a cult.
>You ignored his point entirely, which is that even if we did manage to further lock down our borders, it does nothing to stop community transmissions.
Your statement on the relationship between border control and non-border community transmission is obvious and irrelevant to my statement. Why are you belaboring the obvious?
>Those countries you listed weren't able to control the virus through strong border control
The topic of the comment I responded to was the rapid near elimination of the virus from a country. This was done in the context of fantastically strong border control, which [during this time frame] is a prerequisite to achieving that goal. Now you have changed the topic to "controlling" the virus, which is a relatively vague term and concept.
> The shelter-in-place has not only had this effect, it's been too effective. Hospital utilization in the bay area is at around 10% when you count surge capacity that has been added [1].
This matters if the end game is herd immunity, but not if the end game is to wait out a vaccine, or a sophisticated testing infrastructure. Unfortunately, I don’t think we know what the end game is going to look like now.
I've been wondering for a while what the end game is.
There seems to only be 3 options:
1: Lockdown forever.
2: Everyone becomes immune.
3: Vaccine.
1 is unrealistic. 3 will take a year. 2 the lockdown is too effective - we need at least some people to get infected, and hospitals to be utilized at a manageable rate.
Is there a 4th option I did not think of? Because I can't figure out how they are going to end this.
I guess reopen a state, let people get infected, then close again? Basically a poorly done version of 2?
The idea is not just to keep the curve low initially and then abandon all measures, but to figure out how to keep the curve consistently low over time until a vaccine or highly effective treatment is discovered.
Basically, when you're in free fall and the parachute slows you down comfortably, don't take that as the cue to cut your chute.
Also you may have overlooked adequate testing availability and contact tracing.
And even if contact-tracing is lagging, an abundant supply of testing can at least help to ensure that symptomless or incubating-but-not-showing-symptoms-yet infections can be identified early to prevent wildfire-type spread.
My guess would be that with more tests and resources available, start with a stuttered type approach, open for 2-3 weeks, then lockdown for 2-3 weeks while we wait for new infections to manifest symptoms and for infected to quarantine until they're not infectious.
That could serve as a baseline for what to watch for during reopening, to gauge risk as to whether to repeat with some alteration in timing.
> Is there a 4th option I did not think of? Because I can't figure out how they are going to end this.
Some flavor of mandatory mask/glove/bunny suit wearing and social distancing (e.g. mandatory table-to-table distance at restaurants) would keep the curve flat while allowing a majority of day-to-day life to resume.
Lockdown until you can get back to containment (drive infection numbers so low that you have the resources to trace/test contacts and send possible infections into quarantine).
"Everyone becomes immune" will take longer than vaccine if you don't want to overload your hospitals, and bets on long-term immunity which we don't know yet.
This sounds like a false tricotomy (see what I did there?). Taiwan has effectively contained the outbreak with fewer than 500 cumulative cases for their very dense population of 23m. Unfortunately we can't go back and act swiftly in the beginning like they did, so we'll never approach that level of success, but we can take some lessons from what they continue to do.
I was there in January and February and had my temperature taken routinely to enter populous shopping areas, tourist-packed areas, transit, etc. Mask usage was mandatory in some cases, like buses. They ensured they had sufficient inventory of masks, and even published it so that you could look up which pharmacy to go to. There were lines down the block outside of them, but they also had a reliable ration available for anyone who would wait.
State-side, I haven't had my temperature checked once. Even when I reentered the US, there wasn't so much as a thermal camera to walk in front of (that I could see, anyway). This was the procedure upon entering both Taiwan and transiting through Japan all the way back in January when cases in Taiwan were in the single digits. I can't even find a single mask here.
People were sensible and conscientious there. People voluntarily cut back their social behaviors, but they haven't enacted a hard shut down. It seems to me that we just haven't implemented any common sense behaviors and expect Trump/the governor/Fauci/whoever to come up with some genius plan to solve the crisis for us.
To anyone reading the comment above, it is extremely poor advice and should not be followed.
Stay at home and shelter in place orders are not solely for the purpose of protecting ones-self from contracting the virus. They also serve to limit the spread from unsuspecting carriers. You can carry and spread the virus unknowingly and this will result in susceptible people contracting it and dying.
The only way we know that shelter in place orders worked is if they feel like an overreaction after this is all over with.
We're all scared and desperately seeking answers and relief. We all want this to be over as soon as possible.
But we must put the public health above all else. This is not the time for egocentric defiance of the recommendations from our leaders.
> The only way we know that shelter in place orders worked is if they feel like an overreaction after this is all over with.
That's the only way to know? You think it's reasonable to take away the civil liberties of seven million people indefinitely without at least trying to come up with a better performance metric than that?
You have literally no interest in setting up any kind of plan to assess how the policy is working?
The only people losing civil liberties are the people that die after contracting the virus because we failed to social distance for the necessary amount of time.
The "performance metric" you're looking for is the number of tests we conduct. Unless we're testing hundreds of thousands every day, we have no choice but to continue to shelter in place or stay at home. We are not even close to the amount of testing we need to know who does and doesn't have the virus.
When you have enough tests, you know who has the virus and who doesn't. All those infected (and all the people they've contacted) can quarantine or seek the care they need, and those who aren't infected can all go get haircuts.
So the shelter in place order should be in effect until we have conducted approximately seven million tests, after which we will institute a voluntary program where people who test positive are asked to quarantine and seek care?
I think you're right, we do need a plan, but we need trained epidemiologists and other public health figures to define that plan. Many features of disease spread are counterintuitive and we need people with training to help us, the public, understand the problem and reasonable solutions. When people like Michael Osterholm tell me that it is possible one or two million people will die in the United States, I believe him and I'm willing to go along with the plan. That said, I would like to see more clear definition of where the risk lies, how we can take small chances that have a low chance of going catastrophically wrong, and how we can responsibly try to revert to some kind of normality.
I mean, it's not like this crisis started an hour ago. What's their plan? Like can someone write it down and post in on a government website?
We're all commenting on what appears to be an official government press release that is announcing an entire month of some of the most serious restrictions on the public ever put in place, that does not appear to even try to take any kind of quantitative approach to explaining why that policy was put in to place, and how its effectiveness is being assessed.
Broad, destructive public policy not tied to success metrics is fucking insane and I think the strong negative reactions to it are completely warranted.
Once you commit to some success metric, you're going to be stuck with it even it proves to be a bad metric. Let's say we all agree the "2 weeks with decreasing number of deaths" is a good target. Then we go back to work, and we discover that going back triggers a rapid spread and kills a bunch of people and starts to overwhelm hospitals. Now we need a new metric.
This is a novel scientific problem. Caution and study are warranted. People's lives are at stake.
People's lives are always at stake. That's how public policy works. Like 100% of the time. Try painting lines on the highway or administering a school lunch program without putting people's lives at stake.
The only thing novel here is completely abandoning the concept of public policy goals. There's nothing scientific about setting your public policy without any metrics at all. This is kind of the opposite of a scientific approach.
I'm not suggesting having no metrics, I'm talking about hard targets. Acknowledging that there are things we don't know about the problem and that we're not overcommitting to a course of action based on some specific target is reasonable.
At the same time, to your point, I would like to see clear explanations of "these are the aspects of the disease we are trying to understand (virality, mortality, etc)," these are the constraints on our healthcare system, these are the economic effects, here are the tradeoffs we're trying to make. All of that stuff is good, but it's a complex problem and assuming that we know enough at this point to set a clear numerical goal seems wrong to me. Describing general parameters for our data gathering and decision-making is good, though, and I agree that I'd like to see more of it.
I think that the government agency in charge of the shutdown should be able to answer each of three basic questions with clarity and some kind of numerical response:
1) What are you hoping this policy will accomplish?
2) What sequence of events, if any, would cause you to accelerate your timetable for easing restrictions?
3) What sequence of events, if any, would cause you to delay your timetable for easing restrictions?
I mean those should be the raw basic cost of even having this conversation. I am used to seeing magical thinking and emotional political arguments in many places but I am surprised to see such hostility to a basic quantitative approach on HN of all places.
Your questions are all reasonable. I'm not personally opposed to quantitative decision-making, but I'm also painfully aware of the limitations of quantitative methods, especially when applied under pressure. I would argue that a blind faith in mathematics is just as wrongheaded as the magical thinking you're describing.
To give a clear example of why I'm skeptical, look at the use of quantitative methods to conduct governance in the banking industry. It's not that we shouldn't have used numerical methods, it's just that they ended up being woefully insufficient because of how they were applied. There's no reason we couldn't make the same mistake here in a premature bid for some kind of certainty.
Yeah but this is like setting monetary policy without using interest rates or something. Or coming up with a government spending program and not even trying to do a quick analysis of how much it will cost. It's fucking insane.
Public policy requires metrics and stated goals, and requires that they not be secret. Without those it's not democracy.
We're half-aligned. The decision-making process and the data used to inform it should be public, but I don't think we should be saying at this point "when we see these targets hit we will remove these measures." I think our knowledge is still too incomplete to set that target intelligently.
Nearly uniform testing levels among the states sufficient to indicate that we're getting a real sample of the population, and not the biased sick sample we're getting with PCR testing, would be a start. If you want to be angry about something, be angry that we can't get our act together to get this data collected.
It's going to be a lot easier to win arguments about lockdown when we're confident in our testing data. Right now, nobody is.
You start doing it when you can gather enough information, fast enough to prevent new spikes from happening. The number of "known cases" becomes very low, and then ideally one can react fast enough when new clusters start forming.
When someone comes up with a sane, sensible and actionable plan.
Waiting it out for a vaccine. Even/odd days. Provisioning of masks for everybody. Enough toilet paper to ensure basic sanitation. Enough COVID tests to effectively gauge progress or regress. Rationing. Put all unemployed Americans on the military payroll and make them take turns delivering supplies.
We could look at what any other country who has made even nominal progress with this epidemic have done, pick any single step at random and it would be one made in the right direction.
Instead we've all been told to stay home just long enough to lose our jobs, file some papers and (maybe) receive a paltry stipend, we don't even have the testing infrastructure to know how bad this really is (confirmed cases aren't increasing if the supply of tests isn't keeping up with demand!), and that isn't stopping our syphilitic warlock from telling everybody to take anti-parasitics, drink Lysol and get back out there before it affects his re-election campaign.
There is no leadership. There is no plan. There's a reason this isn't getting better, but letting nature take its course is not the solution.
I understand you feel my characterization is unfair. But the focus on our own personal interaction with the virus without acknowledging how ignoring shelter at home orders can spread the virus to others, is selfish and egocentric.
I do not believe there is room for an alternative viewpoint to that.
> The only way we know that shelter in place orders worked is if they feel like an overreaction after this is all over with.
That makes no sense whatsoever. Millions of children are not vaccinated because of the lockdown. Will the mayor take responsibility for his share of deaths that will occur? Will there be a counter for that, that ticks up every day? And for all the pain and suffering of those that can't afford gratuitous shutdowns?
> it's not about money in my opinion and is about deaths
Are you aware of the fact that people die every day to e.g. deliver groceries to your store, harvest plants, build houses etc pp? Do we shut down all activity that will lead to somebody somewhere losing their life?
The hive mind is terrifying in general. It's bad here, too.
There are mindless zombies arguing for endless quarantine and nothing else will do.
There are mindless zombies arguing that lockdown must end immediately or their freedoms will be irrevocably harmed.
What happened to reason? What happened to recognizing that this lockdown is awful, but useful, and we need to make an intelligent decision about when it ends? There are good reasons to end it now. There are good reasons to extend it for years. The right answer is somewhere in the middle, and only reasonable humans are going to be able to find it.
Mindless hive zombies are not welcome in my world.
They key thing to remember is that the bulk of the voices contributing to comment sections on the Internet are those of people who spend a lot of time time posting comments on the Internet.
I intentionally moved from reddit to HN after this same specific realization. After a few years it seemed like reddit would be a good place for hyper local info on covid, but I quickly saw the same effect— misanthropy in the face of so many people trying to do the best they could for others during hard times. It’s off topic here, but I seriously wonder what specifically caused reddit to adopt the largely toxic culture it has.
My guess for the main reason Reddit feels so toxic would be younger demographic whose primary concern is demonstrating how much "smarter" they are than an average person. The commenting guidelines are also super lax, and the topics covered are very diverse.
Which is mostly the opposite of HN, which skews older and actually more educated, comment guidelines are much stricter, and the topics covered are much more technical and narrow. Even non-tech topics covered on HN (e.g., in-depth discussions of particular judicial rulings) aren't really of much interest to an average teenager or a person in general. Which leads to a few different potential effects:
a) Older and more educated people have much less reason to "flex" how smart they are. The also have fewer occurrences of delusions of grandeur/Dunning-Krueger effect.
b) Niche technical topics have a barrier to entry, which already eliminates a gigantic portion of the toxic audience. The topics themselves are also largely uninteresting to an average person.
c) Stricter comment moderation eliminates a lot of potential toxic material, like every other comment devolving into a shitty attempt at a joke or a personal attack.
And for me, personally, the biggest difference seems to be that on HN, there is a way higher prevalence of people trying to figure out what is right, instead of who is right. I am glad to be proven wrong in an argument here, because it gets me one step closer to finding the "most correct" answer. And the arguments themselves (usually) tend to be very polite. While on reddit, it seems like the vast majority (outside of some specialized and fairly niche subreddits) is just obsessed with proving that their answer is the "most correct" one, so they go all out on the means to reach that goal, which tends to any sort of arguments to become very uncivil very fast.
I think the upvoting mechanism is quite a large differentiator as well.
Upvotes should be for 'contributes to discussion' not for 'I agree'. But it's universally used an agreement/disagreement button on Reddit which amplifies the hivemind massively.
That plus the fact that downvoting is only granted once you've spent a considerable amount of time participating in the community can have a huge impact on the nature of discussions.
Your last point is less impactful recently, as opposed to years ago. Years ago one needed to making numerous substantive contributions to earn downvoting power. Recently, a critical mass of users has been rewarding participants in reddit style humor threads and snarky comments, allowing new users to accumulate upvotes without substance, and without experiencing the more measured culture of traditional HN.
> My guess for the main reason Reddit feels so toxic would be younger demographic whose primary concern is demonstrating how much "smarter" they are than an average person.
Not at all, as the spectrum of this phenomenon matters.
While I can definitely see a lot of people trying to show off how smart they are on HN, they are doing it through demonstrating things and making solid arguments. On Reddit, that is usually done through personal attacks and demonstrating themselves.
So many times I went on reddit and saw someone making a solid argument, only to be derailed by someone going through their comment history and bringing it up as a "aha, gotcha" point in an argument. Even in cases where it shouldn't matter, something like seeing a poster getting downvoted to hell just because one of their comments wasn't critical enough of Trump in an argument that had nothing to do with politics and was purely technical.
A few things I try to remember about Reddit as someone who has used the site for 10+ years:
1. I keep getting older, and Reddit doesn't just stay the same, they get younger. There are a lot of kids on there from age 10-16, and these kids don't just stick to Teenagers and Memes; they will actively comment and discuss politics, capitalism, society, etc.
2. Upvotes mean agree, downvotes mean disagree. In this way, any opinion with even a slight majority will always triumph. If I took 45 Redditors who were liberals and 35 Redditors who were conservative, and both used the upvote and downvote buttons on opinions, then every liberal comment would have +10 and every conservative comment would have -10, which amplifies the 10 person difference by 20. Every opinion you see is one that the majority of the user base agrees with or likes.
3. In both age and other demographics, redditors lean towards young, liberal males with low/no incomes. This causes a lot of bias against certain schools of thought, the role of government in our lives, and people who are on the opposite end of the spectrum - old, conservative (women?) people with high income. It's just a product of the site demographics.
4. The last point I'll make - since Reddit creates this echo chamber of a certain set of ideas and opinions, people who have differing opinions tend to stop posting those opinions or participating in discussion regarding those opinions. What you're left with are the people who are actively frustrated/righteous/feel like wasting time who are spouting against the grain opinions, making those opinions seem even worse to most Redditors than they already were perceived. (For example, if you were wanting to discuss how great you thought Donald Trump was on Reddit, you were most likely not looking for a productive and informative discussion)
There were three huge changes to Reddit culture that I noticed. I might have these out of chronological order, but that's not material to the changes themselves.
The first was when posts started showing thumbnails. This made image content much more viable. Unfortunately, while there's plenty of awesome image content, it's also one of the lowest-effort routes for "shitposts" (the definition of which is left to the reader).
The second was the growth of subreddits. This allowed the community to split and silo itself. As a clichéd example, you can pick your left-wing politics subreddit or your right-wing politics subreddit, and you never have to mix with the other, bad one!
And the third was the death of Digg, which sent a huge influx of people Reddit's way. That one's got a lot of folk mythology behind it and little hard data, so I'll say no more.
Yeah the Digg migration is what killed the site, IMO.
Now that I see this comment thread, I really need to stop visiting that site. It was clearly dead by 2016 and it's only getting worse now. Even subs like /r/ExperiencedDevs and /r/CSCareerQuestions are terrible.
Funny, I've been slowly moving more of my activity back to Reddit for the same reason. I stay away from the bigger subs though.
Don't get me wrong, there's a lot of terrible people there but they're an easy to ignore terrible. When you read something downright asinine there it's really easy to write it off as someone who's 14 and hasn't got the life experience to realize how crazy their opinions are. When you read something asinine here it's attached to a profile that says "senior dev at company X and maintainer of open source project Y" and seeing supposedly smart people be so stupid is a lot harder to rationalize.
Humanity used to be a lot worse, you just didn't have a way of knowing that because ... reddit did not exist. Reddit and social media has generally progressive effects for the same reason that increased communication between diverse people has progressive effects. Yes bad ideas spread but good ideas spread faster
>It's disingenuous to say it used to be worse pre-reddit because there is no data.
It was not disingenuous to state their opinion that it used to be worse, while also noting the lack of data (to suggest that people's perceptions are influenced by the data available).
Agreed, especially when it comes to how easy it is to build a bias. It seems it’s impossible to find any viewpoints that differ from what the hive mind consensus, even if it’s devils advocate or constructive. This likely applies to all forms of social media, including hn.
I do my best to keep within more niche subreddits that mostly focus of interests, but sometimes I find myself pulled into r/all.
I told my wife that I've come assumed shelter-in-place IS in place until a vaccine has been developed. Either that, or herd immunity is to a point where going outside isn't a game of Russian roulette.
As usual, American leaders are choosing OPTION 3 which is the worst option:
OPTION 1. (SWEDEN) Control spread just enough to not overwhelm the health care system, but no more than that, in order to get to herd immunity as quickly as possible. This assumes that the area-under-the-curve will be very similar to any option that spreads the time-frame out. This level of lockdown is possible to implement for long periods of time because its impact on regular life is relatively moderate and it doesn't require extreme testing availability or extreme population compliance.
OPTION 2. (S KOREA) Control with aggressive contact tracing in order to attempt to eradicate or outlive COVID. This assumes that COVID can be controlled and that doing so will ultimately reduce the area-under-the-curve (because if it didn't, spreading the time-frame out would be pointless). This level of lockdown is possible to implement for long periods of time because its impact on regular life is relatively moderate but it does require extreme testing availability and very high population compliance.
We don't yet know what the full impact of 1 vs 2 will be because of externalities that are hard to model, but both seem like legitimate approaches.
OPTION 3. (USA) Control spread aggressively so herd immunity won't be reached for a very long time, do this using a shelter-in-place model that will destroy the economy so you'll be forced to abandon it at some point, have no post shelter-in-place plan so resurgence is practically guaranteed since the goal isn't herd immunity nor aggressive contact tracing.
Option 3 is the most destructive, so let's choose that one.
We already missed the boat on options 1 and 2 due to various governmental incompetencies. Did you not notice that a full third of all cases globally have been in America?
I disagree that we missed the boat on OPTION 1. Option 1 may be the only path currently available to us by removing restrictions in a controlled way.
OPTION 2 is even still a possibility IF we massively ramped up testing and contact tracing. This is possible in theory, but we just not hearing ANYTHING about the real status of mass testing and/or contact tracing procedures (including things like the apple-google app).
It’s frustrating to consider, but if we were capable of the level of testing we would need to re open in the next few weeks, why haven’t we started doing it?
Cases is a very poor metric for this because a country that does zero tests will have zero cases, and therefore look very good.
Total deaths IMHO is much more comparable statistic between countries. By that metric it looks a little better for the US, since we have slightly less than a third of the world death total.
That doesn’t capture what’s important. There are plenty of places that could probably have never closed and not had any real spike in infections. It’s places where people live densely that are at the greatest risk. The Bay Area in particular probably isn’t at the top of that list, but it is still a higher risk area. Really we just need more testing, and randomized testing. I think we would all be able to move forward more intelligently if we had data.
Sorry, I didn't want to enumerate all of the minor permutations. As far as I know, Spain and Italy are also doing OPTION 3. They have no realistic post SIP plan.
YES, but SIP can't stand for long, the people will revolt, a great depression will have other human costs. Choosing the option that's not tenable is bad politics.
The Bay area is not setting up the area for herd immunity -- there are only a hundred cases a day, so it would take many decades to get herd immunity (effectively never, given births and gradual loss of immunity).
There could be anywhere from 5-100x that amount. Lots of people without or with very mild symptoms. Very hard to know without 10-100x the tests we are doing.
Everyone in here is arguing about data and forgetting the context -- we entered this whole mess in a country that has never been so divided. Of course that's relevant. Of course that doesn't go away. The only question that you have to ask is whether you're on Team Fauci or Team Trump.
Why the hell would anyone ever expect the SF local government to ever find themselves on Team Trump, if given the option?
This is absolute nuts. There is no data that is being provided for such heavy handed measures. Virus can kill but that does not mean we should hide indoors for foreseeable future.
States should have let the feds make this decision. The states who hate the feds (california, washington, new york) are also the ones who have the trickiest political decision to make, as reopening in dense cities is always going to be a tradeoff.
The states who like the feds (middle america, texas) have the easiest decision as their states aren't dense.
Now Democrat politicians, who prefer to make intersectional, empathetic decisions have to make the toughest political choice imaginable.
But can anyone share what it's like to not be in either of these situations? How are your rent lords handling things?
I live abroad in a cheap country so I can handle zero income, but I wouldn't be able to last long if rent was $2000+/mo instead of the <$200/mo I currently pay.
Yet when I read Redditors talk about quarantine, you'd think everyone in the world was getting paid time off to play Animal Crossing at home or they live at mom's house rent-free. And it seems like it's this crowd that's likely to be pushing for staying in lockdown with no end in sight.