
How Pandemics Change History - laurex
https://www.newyorker.com/news/q-and-a/how-pandemics-change-history
======
Leary
If locking down a whole city - "cordon sanitaire", doesn't work, why did Italy
just do so? Do they not have the same public health experts, or were they
educated at different schools.

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jacobwilliamroy
What I heard is that it does not stop the virus, but it does slow the spread,
which is key considering that we are currently in a flu season. If 40% of the
population is going to get infected, it's better to deal with them over a
couple years than have them show up all at once.

~~~
bryanrasmussen
actually I wonder if that 40% still holds given the recent news that the study
showing that it could be transmitted by asymptomatic people wasn't correct
(although I guess that doesn't mean it can't be transmitted by asymptomatics,
only that we are back to uncertain)

Then again, the world is not really structured to letting someone with light
fever lay in bed for two weeks so maybe it's the same thing.

~~~
saurik
The references I have found for "the recent news that the study showing that
it could be transmitted by asymptomatic people wasn't correct" are all over a
month old, while the references I find for asserting that new evidence is
confirming asymptomatic transmission is in fact happening are only a week and
a half old. Can you help disambiguate?

~~~
bryanrasmussen
I saw a an article yesterday (I believe it was linked here on HN) it was on
some science site which said basically that everyone was on agreement that
asymptomatic transmission happened because of this study that was done a while
ago but it turned out the study had an improper methodology and the lady they
thought had been asymptomatic (some Chinese lady visiting Berlin IIRC) had in
fact had light fever and weakness.

However this does not mean that asymptomatic transmission does not happen, the
article said that the study had been supposed to be true for confirming what a
lot of people had suspected.

I can't remember the article, I didn't bookmark, also I'm not sure what
computer it was on.

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neonate
[https://archive.md/PxTSX](https://archive.md/PxTSX)

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allovernow
[https://www.evergreenhealth.com/coronavirus](https://www.evergreenhealth.com/coronavirus)

From the doc above, CDC estimates 5% Nationwide will require ICU care. That's
18.5 million people. We have 100k beds. The US medical establishment does not
have the surge capacity for an epidemic of this scale. All of our
manufacturing is in China too - and medicine and semiconductors and just about
everything else.

Only a monumental Civic movement will make containment possible and, as the
article suggests, the pandemic will expose the rot that has gutted this
country over the last few decades, as the system shuts down in an attempt to
contain the pandemic, when the hospitals are quickly overwhelmed.

This is undoubtedly a historic event. Based on the other countries this has
happened in, we are 1-6 weeks, most likely 1-3, away from full outbreak and
the start of widespread business closures and possible food scarcity in some
regions. Stores and truckers may be hard to keep open if no one wants to risk
getting sick.

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all_blue_chucks
If we don't slow this we will overwhelm ICUs, but your math is all wrong. You
assume every single American is exposed, every American contracts the disease,
and every American develops symptoms at exactly the same time. That is flatly
wrong.

~~~
cousin_it
Here's the right math afaik. Over 15% of infected people need a hospital bed
with oxygen to survive (that's the important number, not just those who need
ventilator). Doubling time is a week or less. Hospital stay is two weeks or
more. Infections should slow down once half the population is infected. We can
mostly ignore the time from infection to hospital, because it's a constant
plus a spread that's shorter than hospital stay. So at peak load, 50% of the
population have been infected and passed the initial period, 75% of those have
passed the initial period within the last two weeks, and 15% of those need a
hospital bed to survive. That's 5% of the population or more. Hospital beds
are way fewer than that, so most of these people die.

The only hope is to slow it with non-medical measures. Check the progression
dashboard for your country:
[https://coronavirus.arik.io/](https://coronavirus.arik.io/) You can see which
countries are serious (most of Asia - graph looks linear) and which aren't (US
and most of Europe - graph looks like a hockey stick).

~~~
bsaul
Where did you get that 15% number from ? From my understanding, a huge number
of people infected by the virus are asymptomatic and go completely undetected.
Given that, any estimation is clearly really hard to make, right ?

~~~
cousin_it
[https://www.who.int/docs/default-source/coronaviruse/who-
chi...](https://www.who.int/docs/default-source/coronaviruse/who-china-joint-
mission-on-covid-19-final-report.pdf)

> _Most people infected with COVID-19 virus have mild disease and recover.
> Approximately 80% of laboratory confirmed patients have had mild to moderate
> disease, which includes non-pneumonia and pneumonia cases, 13.8% have severe
> disease (dyspnea, respiratory frequency ≥30 /minute, blood oxygen saturation
> ≤93%, PaO2/FiO2 ratio <300, and/or lung infiltrates >50% of the lung field
> within 24-48 hours) and 6.1% are critical (respiratory failure, septic
> shock, and/or multiple organ dysfunction/failure). Asymptomatic infection
> has been reported, but the majority of the relatively rare cases who are
> asymptomatic on the date of identification/report went on to develop
> disease. The proportion of truly asymptomatic infections is unclear but
> appears to be relatively rare and does not appear to be a major driver of
> transmission._

~~~
matwood
The article says 'laboratory confirmed patients'. Because the large majority
of cases are mild (this is also why the disease spreads so effectively), it
makes sense to assume there are people who went through the disease and were
never tested.

