
Questioning the Clampdown - sbuttgereit
https://www.wsj.com/articles/questioning-the-clampdown-11584485339
======
tunesmith
The last 24 hours have seen some dueling arguments, from respected sources,
regarding how to model this.

This one (pdf) has been highly influential to US and UK governments and is
pretty sobering and alarming: [https://www.imperial.ac.uk/media/imperial-
college/medicine/s...](https://www.imperial.ac.uk/media/imperial-
college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-
modelling-16-03-2020.pdf)

This one is way on the other end:
[https://www.statnews.com/2020/03/17/a-fiasco-in-the-
making-a...](https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-
the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-
data/)

I'm just hoping that we discover effective treatments soon, because with those
we might be able to start treating this like a normal cold before any of the
worst case scenarios would come to pass.

~~~
jtbayly
That first link isn't loading for me. Looks overwhelmed. I checked the Wayback
archive, and it says it has been archived a lot of times, but it isn't
working. Anybody have a working link?

~~~
allisonburtch
the first link is a pdf. try checking your downloads folder?

~~~
jtbayly
I know it’s a PDF. I got it eventually. Did you check archive.org for the url?
As of yesterday it was simply broken.

------
gdubs
About every two weeks since January, it seems there are people who say that
it's too expensive to take bold action. And roughly every two weeks later it
gets much more expensive, and the options become narrower. This, despite
having China, and then Italy, to give us a sense of the severity, and urgency.

These are hard choices. There are no easy answers at this stage. I think
there's also a large degree of cognitive dissonance at play, where people
aren't really able to grasp that this is all actually happening.

Personally, I think we should have done this weeks ago. I think it's good
we're doing it now, but we lost time and it's gonna cost a fortune. Rolling
the dice on this virus feels reckless. That seems to be the opinion of people
like Bill Gates, Taleb, Fauci, etc.

------
ranprieur
The number we need to know is the death rate in the absence of
hospitalization. Because if we let it ride, and the hospitals fill up, that's
the number we're looking at.

If it turns out to be only 1%, then shutting down the economy is probably a
mistake. But if it's more like 10%, then without quarantine we would get an
economic collapse anyway, plus a much higher death toll.

~~~
greedo
A 1% CFR will be catastrophic if we let it ride. Over 7 billion people
worldwide. Assuming a simple 1% infection rate (extremely unlikely consider
the R0 of SARS-CoV-2), that would result in over 700K dying worldwide. And
that ignores the hospitalization required for non-fatal cases. Currently it
looks like 18% of all infections require multi-week hospitalization. So again,
with 1% infection rate, that means over 12 million hospitalizations. And
that's just a 1%/1%/18% assumption.

~~~
Gys
A completely collapsed economy could trigger a society breakdown and will have
deadly consequences as well, like violence (fighting over food, possesions)
and bad healthcare

~~~
greedo
True. But imagine a more realistic scenario based on the CFR we've seen
worldwide. Start with 7B people. Assume 50% get infected because we don't want
to do a lockdown. 3.5B infections means 630M multi-week hospitalizations and
70M fatalities worldwide. And the follow-on effects will kill even more since
these hospitalization rates will consume all our medical resources, so other
illnesses will have higher CFRs as well.

I don't know about you, but avoiding 70m fatalities and over 600M
hospitalizations is the optimal choice. Pursuing this choice would be the
greatest human calamity, surpassing the destruction of WW2 in terms of lives.

~~~
tunesmith
Is there a way to derive infection rate from the R0 value? Because we don't
even get close to 50% infection with the flu, and covid's R0 isn't like
measles or anything.

~~~
SpicyLemonZest
There's no way to derive infection rate at all, unfortunately. Even for
pandemics in the past, where we can go back and look at all the epidemological
data, estimates of infection rates tend to vary by at least 10 percentage
points.

------
leggomylibro
I believe that at this point, any quarantine or 'shelter in place' order must
be voluntary. We stand to lose too much by giving up fundamental rights, and
it is questionable what we would gain from...what, arresting the vanishingly
small number of people who are still blasé about the measures?

Like the article notes, our goal is now to slow the virus, not stop it.
Normalizing heavy-handed authoritarian measures will only breed future
despotism.

~~~
Supermancho
> must be voluntary

Must not be voluntary. Humans are erratic and generally selfish.

> now to slow the virus, not stop it

Stopping it is ideal and when the plague is leathal enough, the only option.
It is not draconian to institute measures that are effective. They will be
instituted eventually (eg if a plagie was ebola with a 60% mortality and 2wk
incubation), regardless of what philosophy you subscribe to.

~~~
Veen
If you have a complete mandatory lockdown that works to stop the spread, it's
highly likely that there will be a resurgence of infections as soon as the
lockdown is lifted.

------
jbob2000
Here's what it comes down to then; Which option is cheaper:

1\. Spend money to temporarily increase hospital beds and ventilator capacity,
but keep everything else running normally, or;

2\. Shutdown everything to slow the spread so that we don't need to increase
bed and ventilator capacity.

I'm tempted to say that adding bed and ventilator capacity is cheaper. I don't
think that option costs trillions of dollars, like option 2 does.

~~~
greedo
The first assumes that increasing vents, ECMOs, and hospital beds is all
that's needed. You'd still need trained staff to man them. Staff that is
extremely vulnerable to this disease. Also, if you don't shut things down,
you'll overwhelm the system, even if you were able to double the number of
beds...

~~~
jbob2000
Do those things cost trillions of dollars? I don't think so. Each country
could probably commit a couple hundred million to this and be better off than
a complete shutdown.

~~~
greedo
In a world with perfect planning, yes it would have made more sense for us to
expand our healthcare so that we could withstand something like this. But we
didn't. We made our bed, and we have to use what we have in hand.

We can't create enough bed space, vents, ECMOs, in the next 6 months. We can't
train enough doctors, nurses, etc in 6 months. So we play the hand we're
dealt, and choose a mitigation strategy that doesn't result in 70M worldwide
fatalities (6M in the US).

~~~
jbob2000
Why 6 months? How much money does it take to do it in 1 month? Is that amount
of money less than trillions of dollars?

~~~
cayleyh
It's not a cost issue. It's supply & capacity issue. You cannot create instant
supply immediately, even with a trillion dollars.

~~~
svanderbleek
Lower requirements by having virus treatment staff with rapid specialized
training

------
neonate
[https://archive.md/KMBQc](https://archive.md/KMBQc)

------
RickJWagner
In the final analysis, it will be said that Trump sacrificed his crown jewel,
the American economy, to save lives.

I think better of him for it.

------
egypturnash
[https://en.wikipedia.org/wiki/Holman_W._Jenkins_Jr](https://en.wikipedia.org/wiki/Holman_W._Jenkins_Jr).

Born 1959. 61 years old.

A quick search for covid mortality by age brings me to
[https://www.businessinsider.com/coronavirus-death-age-
older-...](https://www.businessinsider.com/coronavirus-death-age-older-people-
higher-risk-2020-2?op=1) which puts him in the 3.6% mortality bracket.

If we assume his parents were in their twenties when they had him, they are in
the 80+ bracket, with 14% mortality.

As to what we are getting from this shutdown? Does “a major boost to Medicare
For All and maybe even basic income to substitute for the fact that the
minimum wage has not budged since 2009” count as a thing we get? Probably not,
he got his already.

Or in summation, ok boomer.

~~~
dang
You can't post personal attacks to HN, nor generational slurs, nor flamebait
in general. We ban accounts that do these things.

If you'd please review
[https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)
and use HN in its intended spirit, including right now when stress, fear, and
anger are at higher than usual levels, we'd be grateful.

~~~
jqgatsby
There isn't consensus on whether "ok, boomer" is a slur vs a protest or
criticism. It seems inappropriate to me to ban accounts for using that phrase.

~~~
dang
We don't ban accounts only for using that phrase. If someone just said "ok
boomer", I'd either not reply or do a "please don't do this here"
([https://hn.algolia.com/?dateRange=all&page=0&prefix=false&qu...](https://hn.algolia.com/?dateRange=all&page=0&prefix=false&query=by%3Adang%20%22do%20this%20here%22&sort=byDate&type=comment))
In practice, though, accounts that do that kind of thing tend also to do other
things. Combining it with personal attack is already an escalation.

In any case, it is generational flamebait, which is off topic on HN regardless
of generation.

------
vearwhershuh
Anyone concerned with individual rights should be concerned at the government
responses. H1N1 caused 10K+ deaths and infected tens of millions in the US,
and we had nothing even remotely approximating this response.

This is not to say that we shouldn't be concerned and diligent in our efforts
at containment, but that we should also be concerned and diligent about our
liberty. Right now I see a lot of emphasis on the former and almost none on
the latter, and anyone who voices concerns is labeled a crackpot or worse.

~~~
rovolo
The 10K+ deaths is over the entire course of H1N1/09\. The US had ~4K deaths
from 2009-04 to 2009-10 [1]. Italy has had 3K deaths in just 2020-03 [2]. You
can't directly compare the early state of COVID-19 to the end state of
H1N1/09.

[1]
[https://www.cdc.gov/H1N1flu/estimates/April_February_13.htm](https://www.cdc.gov/H1N1flu/estimates/April_February_13.htm)

[2] [http://www.protezionecivile.gov.it/media-
communication/press...](http://www.protezionecivile.gov.it/media-
communication/press-
release/detail/-/asset_publisher/default/content/coronavirus-
sono-28-710-i-positivi)

