Writing from Serbia. At this point we're at around 105 confirmed ill, 0 deaths. My fiancée is an MD directly involved in trying to contain the spread. In out of the ordinary conditions people just lose common sense. Just think about driving in the rain. That's relatively benign, but when raining I just can't fathom sometimes WTF I'm seeing. Imagine something like a pandemic with yet unknown consequences and spread trend. We've seen hoarding, conflict, disregard towards public health, panic, leisure, the works...
The current action items are:
- No going outside for anyone older than 65
- Curfew from 20:00 to 05:00, with a possibility to prolong it
- Closed borders
- Airports shut down
- No transportation between cities
- Heavily limited public gathering
- Military given law enforcement jurisdiction over civilians
- Schools and universities shut down
And you know what, even with this measures (although I think they are late), it's still very hard to put sense into people and grab this thing by its neck.
Disclaimer:
These measures are controversial in the country, because of the current (autocratic/oligarchic, opaque) political setup, which I am not fond of. There is a lack of transparency in this situation, also. But would I choose any different if asked ? Probably no.
Carantine has its own down sides. It may very well finish as worst solution. Massive H1N1 vaccination decade ago also had its own problem [1] and we are talking here about bunch of other things: effects on economy, domestic violence, etc.
Yes. I don't think most people understand or respect the danger. When 10M-100M of people's lives are at risk, economic considerations must take a back seat to taking extreme/difficult measures that may seem like too much. It's better to overdo it and look overreacting than fail to take actions that could've saved many people's lives.
2. Quite frankly, his argument makes little to no sense to me. He throws out numbers that are exceptionally low.
Italy or Iran seems to be obvious experiments showing that no mitigation is a real issue. And we have alternative real world experiments. I worry that in our attempt to make sure we have validate models, we need critical thinking, not just "nobody knows."
Ioannidis wrote:
"If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths."
The x axis is a week number, the bars represent the numbers of cases and dead per week.
And now it's worse: they already have more dead than China has, and the increase of number of cases and dead still doesn't slow down enough, in spite of the measures that they started to apply (the lockdown of some areas since February 22, of the whole country since March 10).
Approximately the number of dead at the moment doubles every four days -- if that continues for only one month more there will be a half of million who have died, and then 4 days later, a million. That's how fast that goes.
Regarding the "we don't have data" claim: it can seem to be true only when the US intentionally ignores the information coming from the rest of the world. There are indeed countries that have made orders of magnitude more tests than the US (making the number of tests performed in the US mostly irrelevant for this discussion) and the resulting growth of numbers of cases and dead are very steadily independent of the number of tests done, which means that the only numbers that matter are the growth numbers, i.e. that the numbers of cases can't be an artifact of the measurements.
There is no indication whatsoever that the growth speed can change without applied measures.
The data is available, one just has to want to use it.
Something interesting I heard tonight, that I hope someone will look into more, is that there were reports from Italian doctors way back in October / November timeframe of a "strange pneumonia affecting predominately the elderly".
The implication was that coronavirus has been in widespread circulation for longer than people realize, which they theorized was part of why Italy has been unable to contain it.
Normally I'd just dismiss that as rumor, but it was on NPR, and I feel like they normally at least try to filter out the complete nonsense.
Look at the graph from my parent message again -- that info that you cite (coronavirus being active in November) would completely not match what we already know. We know extremely good how fast it spreads and how fast people start to die:
"On 20 January 2020, an 80-year-old passenger from Hong Kong, China, embarked in Yokohama, and disembarked in Hong Kong on 25 January. On 1 February, six days after leaving the ship, he visited a Hong Kong hospital, where he tested positive for SARS-CoV-2.[47][48]"
"On 4 February, the authorities announced positive test results for SARS-CoV-2 for ten people on board, the cancellation of the cruise, and that the ship was entering quarantine."
"Two passengers died on 20 February[78] and a third on 23 February, all three Japanese citizens in their 80s.[79] A fourth passenger, an elderly Japanese man, was reported on 25 February to have died.[80] The fifth fatality, a British national in his 70s, died on 28 February.[81] A 78-year-old Australian national, who was evacuated from the ship, died on 1 March in Australia, making him the sixth.[82] A Hong Kong national from the ship died on 6 March, making him the seventh coronavirus-related death from the ship.[83]"
With the doubling time of 4 days, if the first case had been dying in November and nothing had been done to prevent the spread now there would be million of dead in Italy now.
This has been part of my thinking for a while. A lot of people's models seem to be based on the idea that they know when the first actual infection arrived in a particular area. Given that a lot of people seem to have almost no symptoms at all, that doesn't seem very likely.
I haven't heard that, but I have read (in a source I can't find at the moment) that the first known patient also had bacterial pneumonia and so was misdiagnosed for several days, during which time several healthcare workers became infected, who in turn infected who knows how many.
I'm sure the rate of initial spread, when the number of transmission events is low, is very much subject to chance/luck.
One thing that did occur to me: if it is mostly the elderly and vulnerable who get affected, why don't we concentrate the isolation efforts on them, and allow the rest of the society to live semi-normally.
It's not that I can't be asked to sit at home. Rather:
- There is a huge economical toll from locking up everyone. And it's economies that pay for hospitals
- While everything else is shut, what diseases, damage etc. is done elsewhere? How many people will die because their lesser-priority illnesses get forgotten?
- Would we not be better placed, as societies, to help vulnerable people, if we remained productive?
- Do we get best of both worlds of "herd immunity" and protecting those likely to die?
As a healthy young person I'm fully committed to protecting the vulnerable, I just wonder if the above is better than an all-out lockdown.
It effects middle-age people as well, it’s just that when mortality rate rises from 0.01 (flu) to 0.3% in this specific age group it looks much better than for the elderly with over 10% mortality. 0.3% is still catastrophic and even those who don’t die can have severe long-term effects (see Netherlands cases)
While I'm not defending the entirety of Ioannidis's argument (he makes a couple of mistakes; e.g. we know social distancing has some effect), it's important to point out what his central argument actually is, and how it's different from how the CBC article that purports to describe it. He doesn't assert that the policy response has gone too far; instead, he asserts that in the absence of good data on the pandemic, it's difficult to know whether the policy response is too much or not enough. In my view, on this point he's exactly right.
From the actual Stat article:
"At a time when everyone needs better information, from disease modelers and governments to people quarantined or just social distancing, we lack reliable evidence on how many people have been infected with SARS-CoV-2 or who continue to become infected. Better information is needed to guide decisions and actions of monumental significance and to monitor their impact."
On "we lack reliable evidence": his point is that we don't have what we need, namely an accurate denominator in calculations of morbidity and mortality. "We don’t know if we are failing to capture infections by a factor of three or 300." He's not wrong! In epidemiology, accurately estimating, say, case fatality rates is notoriously difficult - especially in the middle (or the beginning!) of an epidemic. Given the issues we're all familiar with surrounding the lack of testing, this should come as no surprise.
On "better information is needed": I don't think it's that far off-base to say that in the absence of (what asserts is) good data, it's impossible to calibrate policy responses to 2019-nCov so that you're saving as many lives as possible while doing as little damage to the rest of society (e.g. economy) as possible at the same time. This suggestion is eminently reasonable: "The most valuable piece of information for answering [questions about how many people will die of the coronavirus] would be to know the current prevalence of the infection in a random sample of a population and to repeat this exercise at regular time intervals to estimate the incidence of new infections.".
Ioannidis (a physician and an epidemiologist) has made a career out of shedding light on science's mistakes and blind spots, and rightly so. I think the controversy surrounding this piece is overblown: the "fiasco" he's talking about is not a policy response fiasco, but an "evidence fiasco" - without knowing (or, in the US, even attempting to know) the true prevalence and incidence of coronavirus, it's impossible to say how well we're responding.
* Edit / addendum:
Counterpoints to Ioannidis to the effect of "well this is all moot anyway, when faced with high uncertainty about a really scary thing, you act as cautiously as possible regardless of the quality of your data" have a lot of merit. If you're a policymaker right now and you see what's happening in Italian ERs, hell yes you implement social distancing on a mass scale, maybe full lockdown / shelter in place, etc.
But these two sets of tools aren't mutually exclusive; we have a lot of smart and capable people, plus a lot of money, to sic on each. We can allow policymakers to react strongly and cautiously right now to maybe save lives, while also setting up the sorts of basic epidemiological studies Ioannidis calls for: repeated random samples of a representative chunk of a population (e.g. the US population) with the ability to test everyone for corona (preferably using multiple different tests) in order to accurately estimate the denominator.
This. The only way to properly evaluate state of the pandemic is to test the whole population of a country with a test that can differentiate :
- incubating phase
- illness phase
- post-illness with immunity
- fatalities linked with the pathogen
Problem is that the test(s) are currently too pricey both money- and time-wise. Limiting factor here is time, because states push incredible amounts of money to save people.
Furthermore, I could find no reference to assert exactly what the test tests, and its reliability (false negatives/positives) ; this was illustrated by cases of recontaminations that could be linked to incorrect tests.
So now you're a state actor. You've got two choices : either, you play it low regarding extreme measures to contain the pandemic (first reaction of England), you delay measures (like most of European countries, and US), or you act swiftly (China, Korea).
Challenge here is that you won't know if the measures you have taken are too harsh until it's over.
Given the number of unknowns, what will you choose ?
Well let's say that overwhelmed hospital personal, facing dilemnas everyday regarding who deserves to live and who deserves to die, dying themselves to fight the infections, will give you the answer.
It's easy to qualify the reaction as disproportionate
when you don't have skin in the game.
I'd say anyone that believes that the current situation will have no consequence for themselves or their relatives, or who are not aware of the current situation in care facilities and so, downplay it.
It has led to unbelievable carelessness attitude, like people organizing parties after government warnings, transmitting the disease to more vulnerable people.
So yes, everyone has skin in the game, but some people think they have not, until they realize that they have.
I want to know how social distancing can work in the long run. Obviously it slows the spread, but until 60-70% of the population is exposed (200+ million in the US), we won’t have herd immunity. That means we’ll still be fighting exponential growth.
So how long will it take to expose 200 million people? At 10 million a month (horrific!) it will still take two years. No country can afford to spend $1 trillion every quarter to prop up the economy. I’m afraid social distancing merely delays the awful inevitable.
It's not only to keep the number of people needing hospital care below capacity, it will also lower the final proportion of a population infected before herd immunity has an effect [1]. By slowing the spread, it becomes more and more likely somebody exposed to the virus has already recovered and is immune.
To be more likely that the next person to get it is already immune requires millions and millions to be exposed. That’s exactly what herd immunity is. So how long will it take millions and millions to get this immunity.
Sorry for the ambiguous wording: more likely than before a period of strict isolation to be immune. There would still be a spike after isolation is lifted, but the total number of people infected by the end of this wave will be reduced.
Of course, the question is "how much" and whether that's worth the cost. But not overloading the ICUs is valuable on its own.
If the recent study that 90% of people can be virus free after 6 days of hydroxy choloroquine and azithromycin holds up, it seems like we could get through things much quicker than all that.
choloroquine is not a trivial drug. large amounts of it can have ugly side effects and can be quite toxic. exposing everyone to the virus and then slamming them with choloroquine is not a viable option.
In epidemiology, accurately estimating, say, case fatality rates is notoriously difficult - especially in the middle (or the beginning!) of an epidemic. Given the issues we're all familiar with surrounding the lack of testing, this should come as no surprise.
So then why stir up shit right now? It's reckless at best. People are already downplaying the severity as best they can.
Trying to estimate if we're overreacting at the beginning/middle of a pandemic is absolutely trying to stir shit up. We can't reasonably know until much closer to the end.
I suspect that certain pharma drugs given to elder people for cardiovascular and diabetes diseases may be in part responsible for current state. The similar thing was probably partly in effect a century ago with aspirin and Spanish flue.
Anti-inflammatory medication is responsible for some of the death, and NSAID are often taken by people with diabetes (joint pain and stuff like that).
Still, uncontrolled glycemy + covid19 will likely put you to ICU, NSAID or not. If you have diabetes and controlled glycemy, (+ you're young and did not consumme NSAID), you're likely to come out OK.
You are puting it mild. Those people are often on bunch of drugs concurently: ACE inhibitors, NSAIDs, anti-inflamatories. Many of those drugs deplete essential nutrients such as Zinc, vitamin C etc. Maybe that is the dominannt reason why older folks have such incidence. I wonder what are the stats for old & healthy (rare thing indeed, but not unheard of).
What concerns me the most is that many people fail to take a balanced stance. It seems I only hear extreme opinions, but perhaps this has to do with the fact that those with moderate views are not as loud and involved.
I'm fed up with this "it's just a cold" meme. If COVID-19 is "just a cold" or "just a flu", why are ICU's in places like Italy and elsewhere so overwhelmed with severe pneumonia cases?
The person making this argument is a world-respected epidemiologist and statistician from Stanford; he surely deserves more consideration than dismissing his arguments as a meme?
475 people died yesterday in Italy of this thing and tomorrow isn't looking any better...
We all need to act or exactly the same thing is going to happen where we live. We don't need perfect information for that. Italy isn't that fundamentally different from the rest of the western world.
Throw away for the following reasons: this isn’t a point of view I share but I do know that the emotions will take over on this answer, I like my karma but I also don’t want this to be available under my original name here for future out of context quotations.
Maybe the reason is that a large number of the people who are dying today are already on borrowed time. Consider this as an option, just for a moment. The medical advancements in the last 100 years increased the survival chances of many who would not be here already, if not said advancements. Natural selection exists for a reason. We, as a species, are actively working against natural selection, definitely on the medical front.
Thus what we are maybe witnessing today is a natural selection in action.
Natural selection is not something you want a lot of in a human society. We thrive by protecting our weak, it is what allows us to have a diverse population that can focus on becoming smarter instead of stronger. This is why we have nurturing parents and loving relationships instead of the models adopted by other species.
You don't seem to understand how natural selection works. The people whose lives have been extended from 70 to 80 years are well past their reproductive years, so their genes have already been passed on (or not) and their early death due to COVID-19 can't change that. So when the pandemic kills people in that age group it is not affecting natural selection.
Because the normal flu does not kill at a rate of covid-19. The post above does not try to dispute that covid-19 is what it is and is not suggesting that it is a normal flu. We are definitely dealing with something different than normal flu. But you have to consider that majority of the population will go through this without showing symptoms.
What you're saying is "a disease kills people who were going to die from it anyway". No, those people weren't going to die if not for COVID-19, and you can say the same thing for any disease, tautologically.
I remember reading about the Great Smog of London in 1952. Yeah the smog killed a lot of people with 'bad lungs' and underlying disease. Two possibilities is mostly people that were going to die anyways died, or it killed people who otherwise had many years of life in them despite their dodgy health.
Later analyst of the death records showed it was the latter. The death rate increased. But then did just returned to 'normal' The mortality was excess.
You can think of there being two populations of people with health issues who on their way out. And those who are not on their way out. The difference is the former are going to show up in the statics in weeks to months.
If an insult kills the former then they get clustered together in the death records. And after that the mortality rate should drop. Because they're dead already.
If you don't see that drop afterwards it means the insult killed a bunch of people with health issues who weren't going to die anytime soon.
An example I saw was of a WWI vet who had reduced lung capacity because he got gassed during the war. He died during the smog despite being 'okay' beforehand.
Personally I think the argument is hideous. And it's wrong as well. It's a 'bargaining' argument. Of the same genera of argument that justifies doing nothing about sex trafficking because it doesn't happen women and girls from respectable families.
> The medical advancements in the last 100 years increased the survival chances of many who would not be here already, if not said advancements.
Ie "those people wouldn't be here if not for the reasons that let them be here", ie tautological bullshit. Guess what, they also wouldn't be dead if not for COVID-19.
Saying "x wouldn't happen if not for the thing that caused it to happen" isn't some profound statement.
I think people should have right to their opinions but voicing some is sometimes just plainly dangerous.
Yes, we know it works. China has allowed the disease to spread, yet they have instantly turned it around by introducing extreme measures. Just watch this very informative piece: https://www.youtube.com/watch?v=mCa0JXEwDEk
If you are not convinced extreme measures are worth it, just take a look at Italy which still can't get a grip on its population the way Chinese authorities were able to (being authoritative state has some advantages sometimes).
The plague has barely started and they already ran out of space to keep bodies.
If you are of another opinion (that it has barely started) the current statistics show that only half of percent of population is diagnosed (https://www.worldometers.info/coronavirus/) and if you look at logarithmic graph it barely shows any signs of slowdown.
We know there are some asymptomatic cases but only at most 3-4 per one requiring hospitalization which means at most 2-3 percent of population is actually ill. So yes, it just barely started.
South Korea is good example where early, aggressive hunting of cases before they spread brings good results, there was an article on HN recently.
For this reason I think educating people that this is serious matter and we should all refrain from doing things that can spread the disease, if not for our own health then for public safety, is everybody's responsibility now.
This does not mean we have to panic. We just need to understand what is and what is not reasonable prevention. Think about this: if everybody stayed home for two weeks this would mostly be over.
I understand we can't all stay home. Not everybody has a job that allows it. But a lot of people can and the ones that have to move around can do a lot of sane things to make it much harder for disease to spread.
It’s not two weeks. If you want to completely eradicate it you need at least three weeks after number of new cases flatlined completely then clamp extra hard on any remaining pockets
That's why I wrote "it will be mostly over". In two weeks most cases would resolve either way (sorry for being so insensitive..)
And yes, you made an excellent point. The point of not moving around is not just prevent spreading the virus but it also lets authorities to clamp down and focus on remaining pockets, which is just as important.
I'm sure you didn't mean it this way, but I think this is a very myopic take. For many, work-from-home is not an option, and the alternative is just being out of work completely. Many of my friends and family members outside of a few specific industries are already unemployed, moving in with parents (who themselves might be unemployed now), trying to figure out where next month's rent or mortgage payment is going to come from, etc.
Given the vast economic devastation being invoked in order to contain the virus, it's worth taking a moment to ask whether we actually have enough information about its spread and mortality to properly calibrate our response when that response involves making decisions of truly monumental impact.
Now, on the very small snippet of the COVID-19 response which involves technology workers and programmers working from home, I'm among them, and I'm already counting the days until I can get back in the office, as are at least half of my teammates. Most folks I work with do not like it so far. So I think the effect could be the opposite of what you're positing.
I hate to break it to you, but this event as a whole is almost certainly going to be debilitating. WFH advocates will be lucky as hell if this event isn't used to say "WFH doesn't work" for decades.
Personally, I'm WFHing now and I don't like it. Many things are more of a pain in the ass to get done despite me having access to top quality tools to do them with, and many day to day things are much harder and slower to do (quick chats with coworkers about work tasks).
We're certainly facing economic ruin. But it is caused by shelter-in-place and mandatory closings. Those businesses set up for, supported by, and easily pivoting to employees who work from home will suffer less damage than those that require (by policy or nature of work), on-site staff. This is why I'm hopeful that WFH will be seen as a net positive, because it is a distributed system more difficult to knock out.
WFH will not stave off economic ruin from COVID-19. But it may save many businesses from closing.
'As of 9am on 19 March 2020, 64,621 people have been tested in the UK, of which 61,352 were confirmed negative and 3,269 were confirmed positive. As of 1pm 144 patients in the UK who tested positive for coronavirus (COVID-19) have died.'
So that 5% positive and 0.2% death rate of those tested. Seems likely that they would only be testing the worst cases.
When I see data like this but see estimates in the news of 1-2 million deaths in the US it makes me shake my head.
Your numbers are far off. The death rate (CFR) isn't based on the number of people tested, but of people infected. That's currently at 4.4% for the UK. The UK has roughly 68M citizens. If 5% get infected, that's 3.4m cases. Of those, (assuming the current CFR), 150K will die. Additionally, over 600K will require hospitalization for around 2 weeks. The NHS has been stripped of funding for decades, and is in no condition to handle that load.
Not my numbers, but why do you and I guess others think 5% will get infected when only 4.4% of the worst cases are testing positive? Wouldn't sampling the random population result in a significantly lower positive rate?
2.1 Patients who meet the following criteria (inpatient definition)
requiring admission to hospital (a hospital practitioner has decided that admission to hospital is required with an expectation that the patient will need to stay at least one night)
and
have either clinical or radiological evidence of pneumonia
or
acute respiratory distress syndrome
or
influenza like illness (fever ≥37.8°C and at least one of the following respiratory symptoms, which must be of acute onset: persistent cough (with or without sputum), hoarseness, nasal discharge or congestion, shortness of breath, sore throat, wheezing, sneezing
And? The specific testing methodology doesn't prove that the speed of new people getting sick and die will change anytime soon without establishing very strong measures, which is the only information that you need to know.
Calculate yourself the speed in any country, not just the UK. See the numbers 6 days ago, see the numbers 3 days ago, see the numbers now. How many days is the doubling time? Three days. What does it mean? The factor of 2 ^ 10 in 30 days: one thousand TIMES more cases needing hospital in four weeks.
Some numbers now show (with big measures introduced!) 4 days. That reduces the factor to around 200 TIMES more cases needing hospital in four weeks.
There aren't that many hospitals in the world.
Nobody can conclude from the available data that it doesn't spread that fast, as it's consistent across many countries and different amount of testing, it can be concluded just that the virus still didn't spread across all the places it could, and that it's an interest of everybody to stop that spread.
In the UK the number of infected doubles every 3 days. The number of dead at the moment doubles every 2 days. Now starting from 3300 infected today, and 144 dead today, calculate the numbers in just one month. If you think that the growth won't continue if nothing is done, compare with the equivalent data from Italy: just 15 days ago, there were
2020-03-04 3089 infected 107 dead
today:
2020-03-19 41035 infected 3405 dead
and note that they even tried to do the lockdown first of the critical areas and later of the whole country.
Like I've said, the number of tested is irrelevant for the estimate of the future, as the growth speed is stable across many countries, where the number of tests hugely differ:
US 37824 tests 11,604 cases 161 dead
UK 56221 tests 3,269 cases 144 dead
But in all countries the doubling time is also around every 3 days. It's very stable information and allows for easy estimates: 30 days of such doubling makes 10 of them, or the factor 2 ^ 10 = 1024 times more.
Even if the doubling time (for new deaths) increases to 4 days (the number that can now be derived from Italy) the resulting factor in 30 days changes to 2 ^ 7.5 = 181 which still results in almost 30000 deaths in the next month in each of UK and US... as long as something very resolute isn't done to prevent the growth.
But the problem isn't just the dead alone. It's that the number of those that need the hospital treatment is much higher than those that die, and that is when the hospitals aren't overloaded. These numbers are huge. See my other post here for just the number of needed intensive care beds -- those are especially hard to increase.
The factor 4 is also not too important -- with the doubling time of 3 days, it's a difference of only 6 days in one or another direction -- any delays or speedups can easily add up to that. Only the speed of growth is stable and completely consistent information across many countries and what everybody has to worry to reduce.
> "... Tell people to stay at their homes, get depressed, commit suicide, domestic violence. Who knows? Child abuse, children losing their education, ..."
This is so funny. It kind of reminds me warnings about anticipated dangers of early trains:
Critics of early steam-spewing locomotives, for example, thought “that women’s bodies were not designed to go at 50 miles an hour,” and worried that “[female passengers’] uteruses would fly out of [their] bodies as they were accelerated to that speed”—which, for the record, they did and will not.
So you are saying that you know for certain that keeping children home from school... cannot deprive them of an education? And keeping billions of people home, unable to socialize for months, with no end in sight... won't increase depression and anxiety? I'd like to know how you came to those conclusions...
Frankly, the discussion about trains has nothing to do with anything, and should be disregarded. "Once upon a time someone was wrong about something, therefore this person is wrong about an unrelated thing" is silly.
I'm pretty sure kids will be fine despite spending more time with their parents. Vast differences in educational requirements of different countries assure me that possibly whole years of primary education are worth nothing. Besides, main concerns when it comes to closing schools clearly showed that schools are not so much places of education but most importantly storage pens for children so they don't bother their adults.
People who seek knowledge have internet.
And keeping billions at home to socialize just with people who live with them and with people who they can call and connect through internet won't increase on average depression and anxiety any more than going out currently does.
I came to this conclusion by living at home as vast number of people do.
His statements reminded me of the train scare because people had wild theories because they didn't know any better.
This guy should have lived at home and should know it's not some hostile environment you are barely able to spend a night in but must escape every morning or you'll surely go insane. Home for most people is the most cozy place in the world and it's filled with their most favorite people, pets and items.
This is so far from the truth, and it's surprising considering where you're posting. Discord, Skype, Facetime, Facebook, Twitter and Reddit are all places where people can socialize during a quarantine. You're not analyzing the problem properly.
These are not anticipated dangers. These are well-documented dangers. Keeping depressed people away from human contact is damned dangerous. Locking people up in houses with abusers for weeks on end is damned dangerous.
That's not to say that quarantining is necessarily the wrong move. But these are very legitimate concerns, and need to be kept in mind in decision-making.
Vast majority of people are not depressed, are not abused and do not live with their abusers. If your home is unsafe for you that's an individual case by case problem that should be resolved locally and individually, not something that should be taken into account while shaping global policy.
I don't understand your logic. If you believe that policy* shouldn't be influenced by considerations like depression and abuse, why do we have policy about them at all?
The majority of people aren't depressed, yet we have all sorts of public facilities to help them. Do you think we shouldn't?
* You say global policy, but none of this is global policy - it's all national policy.
Policy that attempts to help with depression pertains to depressed not everybody.
Policies that affect everybody don't take into account special needs of various groups because there are so many groups with conflicting needs.
You make one general policy and if that poses some challenge for some special needs group you make another policy for them.
"Stay at home" for everybody. That causes problems for abused? Then make additional policy that ramps up services and education that helps people get away from their abusers. Who knows maybe even occasional contact with police that enforces quarantine will bring their abuse to attention?
Maybe depressed will need special allowances for leaving the house? Maybe not.
What about all the introverts and socially anxious people that will be relieved that their employer is now forced to offer them remote job?
But we can't have global decision that vastly improves something for everybody blocked just because in its unamended form it might worsen conditions for some people.
Writing from Serbia. At this point we're at around 105 confirmed ill, 0 deaths. My fiancée is an MD directly involved in trying to contain the spread. In out of the ordinary conditions people just lose common sense. Just think about driving in the rain. That's relatively benign, but when raining I just can't fathom sometimes WTF I'm seeing. Imagine something like a pandemic with yet unknown consequences and spread trend. We've seen hoarding, conflict, disregard towards public health, panic, leisure, the works...
The current action items are: - No going outside for anyone older than 65 - Curfew from 20:00 to 05:00, with a possibility to prolong it - Closed borders - Airports shut down - No transportation between cities - Heavily limited public gathering - Military given law enforcement jurisdiction over civilians - Schools and universities shut down
And you know what, even with this measures (although I think they are late), it's still very hard to put sense into people and grab this thing by its neck.
Disclaimer: These measures are controversial in the country, because of the current (autocratic/oligarchic, opaque) political setup, which I am not fond of. There is a lack of transparency in this situation, also. But would I choose any different if asked ? Probably no.