
Public health interventions and epidemic intensity during the 1918 flu pandemic - divbzero
https://www.pnas.org/content/104/18/7582
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nostromo
The headline is editorialized in a way that is misleading.

> Early implementation of certain interventions, including closure of schools,
> churches, and theaters, was associated with lower peak death rates, but no
> single intervention showed an association with improved aggregate outcomes
> for the 1918 phase of the pandemic.

In other words, a similar amount of people died regardless of these
interventions, but the cases were spread out over a longer time period. They
also note that the virus spreads as soon as interventions are relaxed,
suggesting many cities just delayed the infection.

Edit: thanks for the comments below - my comment was just to point out that
these interventions didn't cut the death rate in half, as a quick reading of
the submitted headline might suggest.

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ceejayoz
Spreading them out is hugely important if hospital beds and other available
healthcare resources are in short supply, though.

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anoxor
But hurts all the small businesses and people who are laid off due to
prolonged closings.

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nostromo
People shouldn't mock your concern.

Economic declines cause very real harm to real people -- mostly the working
poor.

People lose their jobs, their houses, and their _healthcare_ in recessions.

You may feel immune if you're a tech worker -- and you may be for a time --
but you're not immune to layoffs either.

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merolish
Beat me to it. If this gets bad there's going to be a global recession and
associated political unrest on top of the actual toll of the pandemic.

~~~
thrav
Oil just dropped 30% and the virus is just getting started. It's looking
likely.

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DoreenMichele
_Although the potential benefits of NPIs are supported by mathematical models,
the historical evidence for the impact of such interventions in past pandemics
has not been systematically examined._

My recollection:

There is a book called _The Hot Zone_ that examines the successful containment
of Ebola by "uneducated savages" in the jungles of Africa.

The village elders decided to barricade roads and stop letting in outsiders.
They told their people "Don't go to the white man's hospital" because you
would go with something fixable, like a broken leg, and die of Ebola, which
was killing like 90 percent of people.

They quarantined you by insisting you stay home if you got sick. They would
leave food on your doorstep for you. If the food sat there untouched for three
days, they burned your hut down without going in to check if you were alive.

Obviously, I'm not advocating for burning people's houses down. But it's an
interesting case study of successful containment using _non-pharmaceutical
interventions._

If you are willing to throw things out, disinfect like crazy, limit social
contact, etc, there's a lot you can do without drugs to stop the spread. But
it's damnably inconvenient and most modern people's seem to want to take a
pill and carry on as usual. We seem extraordinarily averse to being
inconvenienced.

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lubujackson
1918 has some good lesssons about controlling viral spread, but there are some
key differences with COVID19.

1918 hit 20 year olds the worst while this virus targets the elderly. The
biggest issue now is the need for ICU care to survive. We know mortality rates
but that implies care, otherwise it turns into Wuhan. Only 90,000 ICU beds in
the whole U.S. and this is the situation happening in Italy right now.

So since the virus is more or less endemic, spreading infections over time is
the best way to save lives. Washing hands and canceling all big group events
at least until summer are the teo obvious moves.

------
billions
I built [https://sneezemap.com](https://sneezemap.com) to help track local
infection levels

[Edit] US cities screenshot:
[https://imgur.com/a/Vzm9wN5](https://imgur.com/a/Vzm9wN5)

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DoreenMichele
Anyone creating a health related website of this sort: Please email me.

I'm working on a thing and would love to be able to include things like this.

~~~
billions
Awesome!

