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This works for a while, but we can't realistically expect to just shut the country down for the next year or so.

I read it more as a "Shut it all down please, then let's figure out which parts we can start to re-open in 4-6 weeks" order.




And 4-6 weeks is long enough for many of the infections to burn themselves out which decreases the R0 and decreases the likelihood of immuno-compromised people running into someone infected.

It's the equivalent of firebreaks in forest fires. We know it's there, let's prevent it from spreading where/when we can.


Not a doctor, but I’m skeptical of the idea that the virus can “burn out” or that we can “starve it.” Is there any scientific evidence to support this theory?

To me it seems like social distancing (“lowering the R0”) can delay propagation but has no effect on the underlying infection rate. It’s hard to see how we are not “delaying the inevitable” with social distancing.

Can anyone clarify this? Sorry if it’s been asked multiple times.


The theory behind "Flatten the curve" is that delaying propagation can buy time for our health care system to better cope, rather than being completely overrun.


I definitely understand that. It seems especially important because of the group of people that needs ICU and recovers. If hospital overflows, they don’t get ICU, so they die.

But it’s a bit discouraging if this is the only benefit of flattening the curve. So we are all gonna get sick, but in an orderly fashion? And the mortality rate is unaffected?


There are definitely more benefits. Every country in the world is now throwing their resources into fighting this. It's much more likely we'll have found an effective anti-viral treatment after the next 4-6 weeks. We'll have ramped up production of ventilators, built temporary hospitals as needed and we should be performing millions of covid tests a day.


Mortality rate without a ventilator is probably what you see in Italy and shortly the UK.

Yes you want to get sick, but the old fashion way. The way I think of it - if we get sick with healthcare services or without.

With healthcare services intact, I likely won’t know anyone who does from covid-19 (1/200, 50% infection rate, 1% fatality).

Without healthcare services I’m likely to know at least one person who’s died. (1/20, 50% infection rate, 10% fatality).

The more we flatten the smaller the denominator.


> The more we flatten the smaller the denominator.

Nitpick: bigger (20 -> 200).


The mortality is affected only in as much as you avoided the much worse mortality rate for the no ICU capacity scenario. This is what we saw in Wuhan and now in Italy. The difference seems to be something like 5x higher mortality or so (1% => 5%).

All of us getting sick in an orderly fashion has a huge benefit even if it turns out that’s the best we can do. But perhaps we flatten the curve for long enough we buy time for treatments to come online and to get closer to a vaccine.


Beside what people write about ICUs, this lets time to buy and build other things like masks, build up the infrastructure, get organized help from the army etc etc.

Also, while a vaccine is far, medication might be nearer. So buying time is essential, beside not wasting that time.


If R0 is driven below 1 the virus will theoretically fizzle out. In practice, it's possible that sub clusters with R0 > 1 will exist that will restart a transmission chain.


viruses “die” when they can no longer hold their infectious structure, presumably due to battling the elements (literally elements and molecules, heat, radiation, etc.), not to mention the active defenses of organisms.

it seems this virus dies in a few hours/days outside of a cozy host environment. so yes, get the transmission rate down far enough and it can die out.


While that’s encouraging (also, username checks out)... I find it difficult to put myself the shoes of a 60-80 year old adult in 3 months. At what point will I feel confident enough that I can leave my house?

It seems the most logical conclusion is that we’ll end up in a situation where the most vulnerable segment of the population remains self-quarantined at least until a therapeutic treatment becomes available, which could be over a year.

I have a very hard time imagining people able to do this.


I'm curious about the behaviour of the very old in Wuhan right now, with other people's regular activity going back to something more like normal (If I've heard that correctly), are the older-but-healthy still staying home too? Whatever the details are, looking to their experience in Wuhan as the disease progresses ahead of the western world's experience is useful for thinking about these things.


well first, you'd avoid threads like this that throw trumped-up early/misleading numbers around to scare the crap out of people. but realize that everyday risks, like getting into a car, are non-trivial too (~1 in 100 lifetime risk of dying in a car accident), but we do them anyway.

more to the point, epidemiologists will eventually reach concensus that the infection rate is under control (close to linear, R0≈1, i imagine). most 80+ year olds might need to stay cautious for the rest of their lives (depending on both the actual epidemiology and treatment/prevention options we develop), but that's true of a wide array of threats, like cancer, heart disease, or even just falling.

so basically, it depends on your risk tolerance once we have enough information to determine the actual risks of dying (vs the guestimates we have so far).


We should have a vaccine sometime next year.


Yeah, everyone is criticizing China for hiding numbers early on. Why is nobody criticizing the politicians in the rest of the world who weren't even authorizing testing?




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