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Effect of economic crisis on America’s small businesses [slides] (docs.google.com)
295 points by mrDmrTmrJ 9 days ago | hide | past | web | favorite | 475 comments





The virus is terrible. But our solution could turn into an economic catastrophe. It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

The solution is aggressive, continuous testing so that people can feel safe going back out.

1. Make hundreds and millions of the rapid tests available. 2. Deploy them to every business, every institution. 3. Test everybody coming into work every morning. 4. Isolate and quarantine the positive ones. 5. Elderly and immunocompromised self-quarantine.

Lets find the actual contours of this infection within the population. And then squeeze it down.

- Want to get into a theme park? You need a negative test result on your phone from this morning.

- You got tested at one of the thousands of mobile test stations. You received a code with your test.

- 15 minutes later, you get a test result on your phone - also sent to a national database in real time.

- The theme park worker scans your phone and validates the result.

This is not a fool-proof system. But it or something like it will instantly reduce anxiety of people trying to work.

If you knew that everyone at your coffee house, at your gym, in your lecture hall, etc. tested negative in the morning. You'd feel safer and we'd all be able to move forward.


China's Red Cross supposedly advised Italy yesterday that 'total economic shutdown'[1] is the only way to contain the COVID-19 situation in the country now.

It all comes to what part of the curve the country is now, the choice being total lockdown incl. economic shutdown vs aggressive testing.

Considering US lapsed on aggressive measures in the beginning and that proper test kits are just being flown in from Italy[2]; total economic shutdown seems to be the only option left.

P.S. There are still high-risk countries which hasn't gone into lockdown neither doing aggressive testing as of now, claiming the number of cases are low although the day-to-day delta is increasing exponentially.

[1]Italy correspondent of Aljazeera gave this information multiple times on live, couldn't find static link to it as of writing.

[2]https://www.msn.com/en-us/news/us/air-force-flew-500000-coro...


> total economic shutdown seems to be the only option left

That's quite the overreaction.

Italy found that among fatalities the median age is over 80 (older than the average lifespan of an Italian man).

99% of fatalities were among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

https://www.bloomberg.com/news/articles/2020-03-18/99-of-tho...

To put it another way: most of the folks dying from COVID-19 were already dying. This disease is the straw that broke the camel's back.

Should we just give up on them? No! But instead of quarantining everyone, and sending us back to the stone age, we should work to quarantine these folks while the rest of us return to normalcy and build up our antibodies and herd immunity.


WHO director specifically mentioned in his briefing yesterday that 'Young people are not invincible and that data from many countries show number of cases below age <50 getting admitted to hospitals make up a significant proportion of patients'.[1]

It's not just fatalities, hospitalisation i.e. exhausting healthcare facilities is the primary concern with COVID-19.

There is no guarantee that young people wouldn't make up high mortality list in a poor country with high younger population, rich countries should get their acts together to stop that from happening in vulnerable countries.

[1]https://youtu.be/6BOKgSCPD4E?t=32


Not to mention complications. Little is known yet, but there are indications that some surviving patients get permanent lung damage. Especially when intensive care is not available. Imagine having 30 million 40-year-olds who will be short of breath for the rest of their lives.

There is no need to imagine, we have the forecasts from the Imperial College report:

https://www.imperial.ac.uk/media/imperial-college/medicine/s...

There are 40 million 40-somethings in the USA, you're proposing that 100% of them will have lung damage.

Let's imagine that 80% of the population is infected, that 80% of cases are symptomatic, and that 80% of the 4.90% of hospitalised cases (this 4.90 is direct from the report) get damaged lungs. This is one million 40-somethings, not the entire population.

1 million sounds like a lot, but its only 2.5% of the population at that age range, and assume worst-case.

You know what causes reduced lung functionality in adults? Asthma, driven by air pollution from vehicles and coal power plants. 7.7% of adults have Asthma. Where is the war-scale drive to eliminate fossil-fueled vehicles and power generation?


So true, I can't understand why climate change hasn't been given the same considerations in the past :(

> You know what causes reduced lung functionality in adults?

Vaping. I see most of the young adults doing this. Its probably why they're having the higher hospitalization rates with coronavirus. They already have lung damage.


> Where is the war-scale drive to eliminate fossil-fueled vehicles and power generation?

Might as well just shut the economy down to eliminate that.


Yes, thank you. So many people are confused about this just being about the # of people dying from covid. The entire health system gets knocked down and all the other preventable diseases that killed us before are no longer prevented.

Stop spreading this. Median hospitalization age is 65. 40% of patients on icu are under 50. With the rates of hospitalization in 30-39 year olds no country would have enough icu beds even for them

This looks correct. Here's the data https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm... Scroll down for TABLE. Hospitalization, intensive care unit (ICU) admission, and case–fatality percentages for reported COVID–19 cases, by age group —United States, February 12–March 16, 2020

Parent was referring to fatality rates and you instead presented hospitalization rates, why do you want them to stop spreading fatality rate information?

When hospitals are full, the fatality rate will approach the current hospitalization rate.

Gonna need to see some actual data. Median hospitalization age of 65 and then 40% of patients in the ICU being under 50 already doesn't even make any sense.

Sure it does. 40% under 50 years old means 60% are 50+ years old. The median is by definition the 50th percentile; aka, at least 50 years old and likely somewhat older, since more than half of all cases are in people who are 50+ years old. Median age being 65 aligns pretty well with that, given that 65 is somewhat above 50.

Maybe a moot question/point, but do we take into account patients in ICU that are unrelated to COVID? E.g. traffic accidents, workplace accidents, heart attacks, etc. I am not trying to spoil the discussion, and I do understand that medical services try to save all lives irrespective of age. So someone who's 80 and is down with COVID and someone who is 25 and fell from his Kawasaki doing 200km/h will each occupy a unit in ICU. That would skew the data.

(my bad, it's not easy to go through the slides on a phone)

Edit: by "skew" I imply mix the two categories COVID Vs "all other causes" and will give false average if we are trying to focus only on the COVID cases.


It's not just old people though. Infants. Immunocompromised individuals. People with asthma. People undergoing chemotherapy.

The narrative that this disease only affects the economically unproductive is dangerous at best, and inhumane at worst.


Honestly, what do you think is going to happen to these people if the economy totally shuts down? it's going to be easy to have a chronic & serious health condition? The same?

My feeling is that I'd rather be chronically sick in a good economy than in a depression. What happens when medicine becomes unavailable due to supply chains being cut off?


"these people" are dying in mass and overwhelming the medical system and even the crematoriums. And they deserve to have quality of life and die with dignity and proper care.

I'd rather a strong, comprehensive public health response than trying to economic recovery ourselves out of this problem. IMHO, the economy is a distraction to numb us from the tsunami of ICU patients and deaths to come.

The economy is not sacred, and is cyclical, and needs a good purge and rebalancing every 8 years or so. Recessions reallocate capital to be used more efficiently. After 2008 they were politicized as something to be avoided at all costs.


The part of the economy that is responsible for electricity, clean running water, food and emergency services absolutely is sacred. The rest of it can maybe be put on hold for a few months; but it will be very painful for many, many people.

What isn't sacred are the people who own all that. They are as disposable as are any other parts of the economic machine. Replacing them is probably a good idea.


> what do you think is going to happen to these people if the economy totally shuts down?

I expect the economic impacts to be rough either way. We don’t have a choice for “no economic impact” anymore. Either we do it in a coordinated and somewhat controlled manner now while we still have a handle on cases vs illness, or the impacts hit, roll, and peak along with the cases of illness while well/well-ish people try to improvise individual responses which probably have similar econ impacts but may not be as effective.

Or did we think that thousands on thousands falling ill at once wasn’t going to hurt economically?


How can you say the economic impacts will be of similar magnitude when looking at the age distribution in severe cases & death here? How do hospitals being overwhelmed have the same magnitude of effect as a literal shutdown of a country? Or, indeed, the shutdown of multiple?

To me it seems likely the difference between a recession (guaranteed) and a real, extremely serious depression which will be fully capable of exacting its own toll on lives.


First, while I fully expect that the worst effects will hit the advertised danger demographics the hardest, at wide enough infection coverage there are going to be poster children for folks who didn't fit that profile[0]. Not just a few.

Second, I expect that the illness impacts will hit even broader, both in sheer numbers and crossing demographic expectations, resulting in people directly absent from work and consumption for weeks at a time.

Those are the first order effects. The second order effects on psychology among a large number of folks having loved ones dying and acquaintances suffering are going to produce some behavior changes. Some of them would be similar to those we're seeing with lockdown, but as I said, improvised rather than coordinated, probably combining some degree of the same impacts but with less of the benefits.

The recession might be milder if we trade a higher death toll. Might.

But the financial markets sure didn't think we were going to escape one even before US civil measures started ratcheting up.

[0] https://medium.com/@juliael84791135/this-isnt-a-normal-flu-i...


Honestly, what do you think is going to happen to these people if the economy totally shuts down? it's going to be easy to have a chronic & serious health condition?

https://www.statista.com/statistics/505995/adults-with-hyper...

The state with the lowest incidence of hypertension still has roughly 1 in 4 adults with hypertension. West Virginia is at the top with more than 1 in 2 adults. What do you think happens to them when they develop COVID-19? Hypertension is at the top of the list of co-morbidities that worsen outcomes. Medication to treat hypertension is often extremely inexpensive even without insurance ($10-$20/mo at the low end) and thus hypertension is often easy and inexpensive to manage.

How many folks working at pharma companies do you think have hypertension? What happens to the supply chain when people are incapacitated?

Even if a minority of the population will need hospitalization (hell, even if the minority is small enough to avoid overwhelming hospitals)... how many do you think will work through a SARS-CoV-2 infection?

The gravity with which I treat this pandemic is in large part based on government action. China quarantined nearly 100 million people. Iran is building mass graves. The uber-pro-business trump crony that serves as the secretary of the treasure took one look at the GOP plan and essentially said "double it, and make it cash with no means testing."

The folks arguing for immediately disruptive action aren't ignoring the economic consequences, they've decided that the economic consequences of doing nothing will be worse.


Let's assume for a moment that governments did nothing.

Obviously, the illness itself was always going to cause an economic blow by killing and sickening people.

And then there would be damage from behavioral changes. People were pulling kids out of schools, canceling events, and avoiding travel without being ordered to do so.

It doesn't seem like the "good economy" you suggest was ever an option.


So what’s your proposed solution? Let’s get back to work, let the fire burn and who dies, dies?

It’s a solution ( it wouldn’t work the way you think, but it’s an option), but at least admit it clearly and live with it.


I'm sure that accusing someone with righteous indignation here feels edifying, but it indicates to me that people are perfectly okay with trading on lives - future ones. At least admit it clearly and live with it.

I think the interesting question (that we don't know yet) is how much of these actions are political because they want to show themselves strong and the public demand some kind of action. And how many of these actions are needed to flatten the curve, prepare the healthcare system and to work on cures/vaccines? For example shutting down schools have a huge effect on society but does it have a similar huge effect on the spread of disease?

How long can you just shut down industries, keep kids out of school and will it make a significant dent in the total mortality? It could be that a couple of weeks of social distancing will be enough but can it be months and what are the comparable effects.

I know it is more dangerous than the normal flu and I will not downplay that but take Italy (that yes, would be worse of without shutdowns) you have 4k deaths so far; mostly old people while a couple of seasons ago they had 24k deaths attributed to a bad flu season.

The social distancing and shutting down society needs to work reasonably fast otherwise I wonder if it is worth it, at least in countries where you already have widespread disease.


The ultimate purpose of the shutdown is to not overwhelm healthcare providers, so people who need treatment actually receive it rather than die waiting in an overcrowded ER. So yes, they would fare better in a shutdown with lessened spread of the virus and fewer people putting strain on healthcare.

Why didn't you respond to the actual point? What do you think is going to happen to people with chronic health conditions in a depression, or when supply chains stop functioning? What happens when (random example) e.g. anti-HIV medicine shipments can't be made and we start to get new mutations in those diseases?

Do you just assume we'll treat chronic health issues as a priority in a depression? I'd like to think we do as well, but the point is that things may well just stop working.


People with chronic health conditions outside of the coronavirus aren't going to get much care in a crammed ER run on triage and therefore serving acute cases rather than chronic if we don't attempt to limit the spread. The staff shortage is worse than any supply shortage. In a healthy economy free of pandemic, CA is short on doctors and nurses.

Quarantine doesn't send anyone to the stone age. The economic shock will be devastating. But there is no long-term, sustained growth without occasional pruning.

Also...

You make the error of assuming that (A) high blood pressure, diabetes, and heart disease mean that a person is "already dying," and (B) people who survive don't become debilitatingly sick.


Some of this economic damage is also the result of toppling imbalances that have been artificially propped up since before 2008.

The virus is just a convenient excuse; a crisis would have hit at the first sign of trouble.


> The virus is just a convenient excuse; a crisis would have hit at the first sign of trouble.

Sure, the market was seeming to be overheated and due for a correction.

Without the virus, maybe it's 2008.

With the virus, it's starting to feel like 1929 again.

Huge numbers of people are unemployed right now that wouldn't be in a normal recession.

Wait till the unemployment numbers come out.


We haven’t built herd immunity to the flu despite millennia of trying.

This thing has evolved three strains with only a couple hundred thousand cases. A couple billion turns it into a shit show.


> Italy found that among fatalities the median age is over 80 (older than the average lifespan of an Italian man).

Selection bias. They're so overwhelmed they're using age as a primary factor to triage patients. Clearly, if you put your medical resources towards saving the younger patients, the younger people are going to have a better survival rate. Lack of a ventilator, when you have a severe lung disease, is a massive risk factor at any age.

> 99% of fatalities were among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

Again, if you look at the oldest people, you're probably going to find more diseases there. This could easily be just another consequence of age-based triage.


You will get tarred and feathered for your comment but you are correct.

Here is why you'll get tarred and feathered, because right now the media is covering the health costs of the virus extensively, but it's not covering the economic costs, which are already unfolding now in the form of businesses dropping vendors and announcing layoffs because their anticipated revenue until further notice is zero.

I've seen so many bros on my feeds who puffed out their chests a month or two ago and said, this virus is not a big deal. Then there were cases in their state and the media was reporting the deluge of new cases in the US and they said oh I was wrong, we need to be on total lockdown, and they're hiding in their apartments.

What will happen next is the jobless claims will come in, which we can clearly predict based on current business activity, and they will break records. I saw one estimate of around 1.5 million jobless claims this week, which is a record. I guess the bros will start squawking about the economic damage in 2-3 weeks once the media has covered this widely and people they know are out of work.

Small businesses (and some large ones too) typically don't have large cash reserves like Google. They also don't know whether this will last for one month or six. So they are in the process today of shutting down and telling everyone to go home without pay, they have to do this until they know what the long-term outlook is.

Nothing changes, most people are sheep, they parrot whatever's in their feed, they are poor at prognostication and self-examination, their attention is occupied by whatever narrative is being shouted most loudly. Nothing you can do.


I noticed yesterday for the first time that there is starting to be some discussion about the damage caused by the lockdowns. Before that I was amazed that no one was interested in even discussing it. So there seems to be a trend of people waking up to it. Thanks for your brave comment. Bros are slow ;)

Take a pause for 2-4 weeks and reevaluate. Everyone has a 6 month buffer right..? :)

I dislike this hyperbole. I still have electricity, running water, heating. Where is this stone age? Where is my cave?

> Italy found that among fatalities the median age is over 80 (older than the average lifespan of an Italian man).

> 99% of fatalities were among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

This is true, but what about the overcrowded hospitals this causes? People who weren't gonna die will now die. And what do we do about the doctors and nurses who are pleading with everyone to act?

Perhaps something along the lines of strict contact tracing could have been done, but now it seems like it's out of hand.


Death rate is still pretty high for young people, too 0.5 - 1%. I wouldn’t take that risk.

> 99% of fatalities were among people with a prior illness. About 50% of the deaths were people suffering from at least three other illnesses.

So far... wait until you get the number of critical cases above the number of ICU beds and you'll see 18 year olds dying from this


Based on what? According to the Bloomberg article -

”As of March 17, 17 people under 50 had died from the disease. All of Italy’s victims under 40 have been males with serious existing medical conditions.”

They reached maxed capacity of beds or ventilators right? We read stories of doctors having to make life & death decisions. Where are the dead 18 year olds?

Spreading info like that on a hunch, or an exaggeration, is counterproductive if not damaging.


Current situation in Geneva, Switzerland - 2 critical male patients, one 27, one 29, no prior comorbidities at all. Not sure they will make it. Wife is a doctor and just checked this in their information system.

The idea that relatively young (most of folks here) will be just fine is not true. With overwhelmed healthcare, most criticals will simply die. Once doctors will get sick (and they will), it will make everything, I mean literally any disease and injury much more dangerous. Sure, most will survive, hopefully without any permanent lungs/kidneys/testes damage (was this confirmed or just a rumor?).

Maybe as humanity we've grown weak and can't tolerate medieval mortality rates anymore, but this is who we are right now. There is no easy solution to this. There is unavoidable harsh economic impact coming. Nobody has clue which option will be at the end better than others.

Accept it, and try to find ways to help fellow human beings instead. We are in this all together, rich and poor, left and right alike.


Two examples doesn't change the stats. There were 0.8% of deaths in Italy that did not have any prior comorbidities. Picking two of those examples does not increase the 0.8%.

I don't think any one is under some kind of delusion that some young people will die. The only question is what percentage and what changing those numbers will cost. Picking specific examples of bad outcomes and pretending the risk is as high as older people isn't doing anyone any favors.


>Current situation in Geneva, Switzerland - 2 critical male patients, one 27, one 29, no prior comorbidities at all. Not sure they will make it. Wife is a doctor and just checked this in their information system.

I don't know about the law in Switzerland but unless you are lying that is something she could be fired for in many countries.


For checking overall status without going into details? All doctors within given hospital have this kind of access here. 'Many countries' sounds rather like very few for this case, aren't you thinking US specifically?

It is as tough in Sweden, doctors and nurses have of course access to patient files but every access is logged and if someone is caught accessing files about a patient they are not working with they will be reprimanded or fired.

The last thing hospitals want to do right now is to fire doctors.

I mean sure, but I was just saying that countries outside US takes unauthorized access to personal medical data incredibly serious.

> They reached maxed capacity of beds or ventilators right?

They just started to reach max capacity, and not in every region, every hospital at the same time...


Fair enough, I should have said, ”In some areas”. A little snippet from the CDC I have posted a bunch that I found useful -

”Pandemics begin with an investigation phase, followed by recognition, initiation, and acceleration phases. The peak of illnesses occurs at the end of the acceleration phase, which is followed by a deceleration phase, during which there is a decrease in illnesses. Different countries can be in different phases of the pandemic at any point in time and different parts of the same country can also be in different phases of a pandemic.”

So, we know not all the hospitals are experiencing the same levels at the same time. A big reason I wish we were more precisely targeting shutdowns and quarantines.

It doesn’t make sense to throw these blanket executive orders over entire states. As we can see from the slides, the economic consequence are dire. Why not target the cities entering acceleration only?

In the meantime, start building drive thru testing. Distribute thermometers. Practice social distancing & aggressive sanitation, but not destroy out national security in the process.

But this part,

”All of Italy’s victims under 40 have been males with serious existing medical conditions”

Sure it’s early, but even in Italy, in one of the worst places in the world for the virus right now, that information should be very illuminating to us I think.


> Why not target the cities entering acceleration only?

Because the long incubation period and the lack of sufficient testing makes it impossible to know which cities are infected early on.

And, to put more bluntly, because we have two models to look at and choose from: the Chinese one, with harsh containment measures that were very effective (if you believe their numbers) and the Italian one, with moderate containment measures and a lack of sense of urgency from the populace, which resulted in a downward spiral with more deaths than China despite having only ~58% the number of cases.

> I should have said, ”In some areas”.

And no, you shouldn't have said that, you should just wait another week.


Here is a fresh preprint from University of Padova showing that weak quarantines have no significant effect:

Quantifying undetected COVID-19 cases and effects of containment measures in Italy

https://www.researchgate.net/publication/339915690_Quantifyi...


You won't, because we triage patients.

Triage isn’t a cure

No, but it's something every software developer understands is necessary in every system every day.

Ventilators are first come first serve. Once someone is on a ventilator it’s not like you can unhook them for a younger patient.

Not any more:

"With demand outpacing supply of beds and respirators, medical workers are told to prioritize younger patients."

"The principle of "first come, first served" has been abandoned, said Mario Riccio, an anesthesiologist who works at a hospital in Cremona."

- https://www.politico.eu/article/coronavirus-italy-doctors-to...


And there are always ventilators becoming available and patients getting triaged for their order in line (if there is a line).

I wish I could upvote this about 50 more times.

Can we make millions of the tests rapidly available? I am still reading about test shortages on both coasts, even under the restricted testing regime we have been in so far.

Maybe the no-contact thermometers could be a scalable approach. Go to the bank? Forehead scan to get in. Go to the grocery store? Same. At least until--and maybe even after--we can scale the RNA testing.


> Maybe the no-contact thermometers could be a scalable approach. Go to the bank? Forehead scan to get in. Go to the grocery store? Same.

This is the reality in China. Literally every single public place have a remote thermometer they scan on your forehead. supermarket? scanned. subway? scanned. restaurant? scanned. If you have a fever you'll go into quarantine in no time.


People can take ibuprofen prior to going shopping.

People can do a lot of things. It's not a big deal that measures won't be perfectly effective - in the presence of any suppression measures, once the case count stabilizes, there's a lot of room between "literally impossible to spread the virus" and exponential growth.

That's nice, but one such person can shut down the entire production line in some factory, or the hospital department. (happened already in my country) Such people have disproportionate effect on the economy.

Get IDT or (other nucleotide synthesis company) to start mass producing the detection primers, and ship them to their whole active customer catalog, they all have thermal cyclers. Then figure out the other reagents needed to locally produce tests that trade off false positive rate for the lowest false negative rate you can get. How to get swabs to the closest lab with a thermal cycler, no idea, but we have phones with gps. Rate limiting step here is probably the step from swab to sample ready for amplification. I kind of wonder if it makes sense to tell people to start swabbing now and keep the swabs in the freezer until testing comes online so that we can start filling in the missing data.

I really feel like you guys are ignoring a lot of the difficulties in ramping up production to nation scale for this hypothetical test. A "rapid" test no less. These things are not as easy as everyone is making them out to be. Making one? Simple. Scaling that up to 8 figures worth? Not so simple. A lot of us are being a little too Jedi hand-wave-y about this issue.

And think about it, I'm only talking about getting up to 10 mil or so here. We'd need a lot more than that to implement the plans being proposed on this thread. Logistics really does demand that medical personnel, and emergency responders be tested regularly to ensure their continued fitness for purpose under such schemes. Consider, there are right around 12,000 law enforcement officers alone in Washington state. Not counting doctors, nurses, EMT's and firemen. (And lest we forget the most important emergency worker of all right now, the Walmart stock boys.)

Add all that up. Multiply it by 50 states, some much larger than Washington. Under the plans you guys are proposing, we'd need multiple tests as the crisis goes on for each of these workers to make sure they aren't out infecting citizens when they interact with them. (Or when they put food on shelves that a customer picks up 4 hours later.)

Please, try to be reasonable. Maybe the current approach is not tenable, but the ideas being proposed on this thread are problematic as well.


Aren't there multiple existing labs all over the country who do this regularly? Are these tests made in small batches or something? Do you need to grow viral cultures? What exactly is the limit here and why can't a typical lab just double production in a few weeks by doubling it's hardware?

You don't have to culture anything (if we did we might as well just give up). We use PCR to amplify a known section of the viral genome. With the oligo production capacity in this country alone we could synthesize enough primers test everyone in the country 10 times in a couple of days. That is not the limiting reagent. The limit is either sample prep or sample collection. Actually running the amplification shouldn't be a bottleneck, there are hundreds of thousands of thermal cyclers across the country. In my more cynical moments I might say the bottleneck is that some companies might want to make money from all the tests ....

I'm trying to learn a bit more about how testing works. Aside from the logistics (getting the samples to the lab, etc), what are the necessary steps for sample prep? Heating to inactivate the virus? Splitting the sample into RNA/DNA/proteins?

Also, where do you draw the numbers of primer production capacity from? IIUC, the only other things that an amplification needs are enzymes (just DNA polymerase for PCR) and "food" (nucleotides), but that I assume is not a bottleneck?

How difficult is it to safely dispose of amplified samples? Can you basically just dump them in the toilet?


Well, figuring all that out sure seems a lot more fun than sitting and waiting. I take dying trying to do something useful over just dying.

Like in war profits will probably be huge but if there is enough pressure government cna seize stuff too.


Yes I am also cynical about the situation. There is something not insurmountable standing in the way.

Asymptomatic transmission is the key here. It's why "stay home if you're sick" or denying entry to detectably sick people isn't enough.

Considering that people generally go to work even when they're sick in the US, and that people are scared to go to the doctor because of the hidden cost, I don't think your solution is valid.

On the other hand, we cannot pause the economy for too long. The damages are already done but what is going to happen if we wait too much?

I cannot imagine the level of stress the people working at the government must be under now... Whatever solution they come up with could be the collapse of the US as we know of now.


>>Whatever solution they come up with could be the collapse of the US as we know of now.

Pretty sure that ship already sailed.


> It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

Why not? This is a matter of survival. If the economic system breaks because of one pandemic that will last less than a year maybe that economic system needs to die and be replaced by something more solid and useful for most.


It's not about abstract "economic system".

Let me put it in simple word: you'll loose your job. Your friends and family will loose their jobs.

As a result, when your savings run out, you'll loose your appartement. And so will your friends and family.

You won't be able to afford food without government assistance.

And even if shutdown lasts only 30 days, it'll wreck the economy for a long time. Once a restaurant defaults and closes, it won't just re-open. Those jobs will be lost for a long time.

Now, maybe you're one of the lucky ones with enough savings to ride this out and this won't affect you. But it'll affect millions of others.


Why do we need jobs to survive? That alone is an insane system. We desperately need to separate work activity and survivability.

Even without this pandemic, we live in a World where there is enough shelter, food and drugs for everyone but we still have homeless people, people starving or at the least malnourished and people dying in a rich country because they have to ration fucking insulin.

This economic system is not working at all. People die every die directly because of this system[0]. This pandemic just brings it to light.

[0]: https://en.wikipedia.org/wiki/Structural_violence


Yep, this situation is a socialist wet dream

Of course socialism is a failed economic model but hey maybe this time it will work /s


How is it a failed system? I'd say people cannot afford insulin is proof enough that Capitalism is a failed system.

Just go ask Argentina[0], collapsing months after IMF was praising the "good" work Argentina was doing and how a good Capitalist country it has become[1].

This pandemic just made most people feel what the lives of billions is like all year long under Capitalism. And your dismissive comment is just shameful and disgusting.

[0]: https://en.wikipedia.org/wiki/1998%E2%80%932002_Argentine_gr...

[1]: https://www.imf.org/external/pubs/ft/fandd/2000/03/pou.htm


>>How is it a failed system?

ohh I dont know, the millions upon millions that have died in starvation due to socialism over the many decades that it has been tried

but those where not "real socialism" right....

Pointing to one good that some people can not afford (the reason is largely due to government control not capitalism BTW) does not in any way "prove capitalism failed"

it is true that sometimes with capitalism you will get breadlines, but with socialism sometimes you get bread


It's really something witnessing /r/the_donald spill over here.

It is really something to have people confuse libertarianism with Donald Trump

All of those are the result of the horrible 'economic system' we find ourselves in. People lose their apartments when they lose their jobs because we have few safety nets. And for small businesses we're demonstrating how little it takes for something to completely destroy them.

If humanity can't react appropriately to pandemics like this, then how can we expect to survive in the eventuality that something even worse comes along? And any economic system that gets crushed by this proves that it simply wasn't prepared and needs to be replaced, lest it cause even more damage to individuals.


We don't need restaurants. If you cook your own food the empployees can find a useful job. Until they do we can sustain them just like we could sustain them while doing useless work.

You cannot imagine an economic system where the default state of a human being is to become destitute?

People are going to be destitute if nobody is producing goods and services. Money is worthless if there's nothing to buy.

I think one thing that this pandemic is teaching us is that most people's jobs do jack shit to maintain the basic needs of society, and the ones with important jobs are often paid the least.

> the ones with important jobs are often paid the least.

that's the wrong way to think about it, and also a misunderstanding of economics.

If a teacher is paid the way a CEO is paid, there won't be enough money for very many teachers. You'd find it hard to afford a teacher for your kids, let alone free education.

A doctor, back in the middle ages, is only affordable to the nobility. These days, doctors are still quite highly paid (too high imho), and that is one reason why medical services are expensive.

Imagine if you associate the "importance" of a resource with its price. Water would cost more than diamonds and gold! Water is needed for sustaining life - you die without it. Therefore, in theory, it's so important that you end up paying infinity amount of money to have it, under your system!

The fact that we have water so cheap (literally 0.000001 cent per cup), is a good outcome. Everybody can afford water.


CEO of what? Bullshit inc?

> If a teacher is paid the way a CEO is paid

You are thinking about it wrongly. We should pay the CEO the same as the teacher. Managing a bunch of adults can't possibly be harder than teaching children. Education is an actual investment. Bullshit inc not so much.


The beauty of capitalism is "we" don't decide CEO pay. The owners of the company do, and it's paid out of the owners' pocket.

Anyone is free to start a corporation, name a CEO, and pay him whatever they want to (from their money). They can even name themselves CEO!


> The owners of the company do, and it's paid out of the owners' pocket.

This is not true for publicly traded companies - where the board (consisting mostly executives at other companies) determines compensation on behalf of the owners


The board members operate only at the pleasure of the shareholders, so the shareholders ultimately determine CEO pay and are the ones who are paying it. Shareholders can (and often do) sell their stock the moment they don't like what the board and CEO are doing.

I'm sorry, I should have explained what seems so obvious to me. Let me try put it more sensible...

We have a finite amount of labor and a finite amount of resources available to us.

The thing our governments lack since the days of lords and god kings is direction. This is necessary since a group of people poorly working together isn't smarter than the smartest person in that group.

We all do stupid shit at times, if a lot of people decide to support the same stupid thing it is entirely possible to dedicate all time and resources to throwing virgins in the volcano, smoking opium or borrow money in stead of printing it. Who knows, someone might create the ultimate video game, we could retool our entire civilization to play the game non stop.

A [proverbial] god king would have other priorities, there might be a war coming with the neighboring country, there might be regular floods, there might be an insect plague, there might be a disease or the food might be running out.

We have distributed wealth recklessly (to put it blunt) and ended up with millions of little emperors who pay their little generals whatever they like. They are constantly at war with the next little empire.

The plague or the flood simply become economic developments that one can leverage for ones advantage. What is left of our government is a vending machine that one can use as a weapon to do whatever each little empire is willing to pay for.

I should mention we've made a ton of technological progress with this role playing game. It might just be that we've created the ultimate game already and that everyone is playing it. If so I'd have to argue we have one shitty dungeon master. The adventures planned out for most of us are not very interesting. Most of us are simply chasing the carrot on the stick. The heroes are not gaining as much experience points as they could, they are not learning as many new skills and abilities as they could. We can do better and we know it.

Say you are in charge for sake of argument. The orc's are getting ready to attack from the east, the goblins from the west but all your population cares about is opium. Would you dedicate resources to making swords and training or would you give the CEO of Opium inc in his competitive struggle with Meth corp the 10 000 men he wants for a promotional parade? The people might be enraged. If we make swords who will care for the poppy fields??

> Anyone is free to start a corporation

Indeed, I could create a product triggering superior production of endorphins. I could win a large market share and then present myself as if a philanthropist on a mission to help humanity with its struggles. I could prove it by moving funds into a non profit organization that might not do anything by design or struggle hard not accomplishing anything.

It's almost funny, the real needs retooled into a vehicle for public relations. If you play enough candy crush we will be sure to defeat the orc's.

Thanks for your time.


> We have a finite amount of labor and a finite amount of resources available to us.

There is an infinite amount of labor available - because of improvements in efficiency. The manpower required to make a shirt has declined by something like 99% in the last 200 years. For growing food has dropped a similar amount. And on and on.

Resources are infinite because they can always be re-used and re-purposed for other things. For example, despite everyone eating chicken and ham, there is no looming shortage of chickens or pigs, because people figured out how to raise them efficiently.


Certainly, we live in interesting times. The capabilities are all there, what is left of the puzzle is tying it all together.

Gradually manpower to make a shirt has declined by 99%. It happened gradually so we continue to have more garment workers than needed. This is driving down salaries and it removes job security which again improves productivity.

I've seen stuff from up close that was much to ridiculous and I live in the Netherlands. I take all kinds of weird jobs just to see what things are like.

The latest trend is to reduce the work week from 5 to 2-3 days and the work day from 8 to 4-5 hours. That way you can make people work at insane speed. (Speed no one could work at for 40 hours)

In one such job (which wasn't the most idiotic example at all) a group of 5 people produced half a million boxes of cookies in a day. The conveyor belt moved so fast one couldn't scratch himself. After taxes I got 35 euro per day.

I kept getting back to the same thought. Do I need cookies to cost 99 cents per box? How terrible would it be if they cost 1 euro? Would we raise our nose and push the shopping cart ahead thinking "how dare they ask this much money for cookies?!" When shopping I couldn't care less if it costs 99 cents or 1 euro. I'm not saying we should pay people 1000 euro per day. I'm saying the customer certainly doesn't care if prices go up by that much. Only the Joneses would cry about it. They would demand salaries to go down to the appropriate 35 euro in a country where rent is 800. You'll just have to work 8 weeks to pay for it, you figure it out! You should have paid more attention in school then someone else would have had to package the cookies!

I can see how that line of reasoning works on an individual level and ill certainly make it work for me myself and I. I don't consider the societal puzzle solved like that.

On the second day I asked a manager if I could take a box of cookies. He couldn't look at me, he looked at the floor, then at the wall, then at the ceiling, then back at the wall. After 10 long seconds of silence he said, no not today sorry.

It took me days to figure out what thoughts were behind that expression, it was a simple yes/no question in my book... Then it struck me! The legal limit of gifts for employees (which includes product) is 1% of the salary! Having worked only 2 days there was no room to gift me the 99 cent pack of cookies.

At the end of the 3rd work day I found the manager at the exit. He proudly pointed out a pallet of test product. 1 box per person! He said!

Since I take such jobs somewhat as a corporate spy I had already learned that those boxes will be unpacked and the cookies will be sold as pig food.

Reading the expressions on his face this charade was much more painful for the manager than the employees.

The rules for taking cookies home were much less strictly enforced when people worked full time. No inspector would have considered it paying salary in cookies.

For the 4th time they are building a whole new factory now. I'm sure they will ramp up production to at least a million boxes per day. 3 out of the 5 jobs can be automated easily.

1 cent extra would then allow us to pay 5000 euro per day. Imagine how angry people would get?

Garment workers:

https://sustainablebrands.com/read/marketing-and-comms/garme... "On average, they worked 60 hours a week and earned an hourly rate of 28 taka (the equivalent of $0.95 in purchasing power parity). They earned less than the minimum hourly wage 64 percent of the time and there was significant evidence to suggest that the more they worked, the less they earned."

forget ppp, 28 taka is $0.33

I'm simply suggesting we should build that world you portray rather than pretend it already exists.


You literally cannot imagine an alternative to capitalism.

No need to imagine it. There are plenty of history books documenting life under those alternatives.

No thanks.


> If the economic system breaks because of one pandemic that will last less than a year maybe that economic system needs to die and be replaced by something more solid and useful for most.

Out of curiosity, why do you think it's likely that something more solid and useful to most is likely to come out of an economic collapse? Economic collapses have happened before - are there any instances of a solid and useful system coming out of them (maybe the new deal after the great depression? That one is arguable though).


Imagine if we had a system where you don't have to pay for any basic necessities, from shelter to food to healthcare to education.

We all work in the system, some would make more than others but even those who work the least or not at all would not be left behind. So if you make more you can enjoy more "stuff" and gadgets and if you make less you are still stress free about life.

Would we have $1000 phones or shopping shelves filled with hundred of fake choices? Most likely not but at least we won't have people rationing insulin or people living in the street of the richest city in the richest country.

We live in a world with so much production and people spend their time worrying about surviving and getting ahead instead of relaxing and making the world a better place.


Perhaps it's rare due to man's tendency toward corruption.

Are there reasons you see why a more robust cannot be developed? I suspect HN could easily come up with a substantial list of improvements. Limiting stock buybacks seems like a good place to start.


French Revolution? Arguably the Russian Revolution if you accept the USSR as a step up from feudalism.

> French Revolution?

Didn't even last a decade until they got themselves an emperor.

> Arguably the Russian Revolution if you accept the USSR as a step up from feudalism.

Considering that the USSR killed orders of magnitude more of its own people than feudalism under the Czars ever did, I'm going to vote "no" on this one.


It also brought an unprecedented amount of economic development to what was an incredibly backwards country.

Not that it's a model to imitate. Although some folks in this thread sound rather ready to sacrifice millions of people, for the sake of keeping the economy limping along...


> Although some folks in this thread sound rather ready to sacrifice millions of people, for the sake of keeping the economy limping along...

That’s because they believe they are young and would fight off the virus with no problem. Change one of those variables and they will change their tune.


I can understand that it is prudent to take a worst case scenario here but it depends on how widespread this thing already is without us knowing it.

So Sweden has right now 1,639 confirmed cases with 16 deaths so far. There are some young people treated in critical care but so far it has been older people who has passed away, often with other diseases as well. Sweden currently only tests older people, people with severe symptoms, healthcare workers and similar personal and those who can work from home these days and travel is discouraged.

One expert estimated that we have around 100k infected in total right now and discussed that some things like shutting down schools for younger kids will have a large effect on society but not do that much on the spread of the virus. Instead you should focus on protecting vulnerable groups, stay home if you feel any symptoms of cold etc.

100k out of 10 million population would fit roughly with Iceland who did random sampling and found 1% of their population affected.

Of course he acknowledged that there is no way to know and taking extreme measures are better than taking too small but emotional/political reactions vs practical is really a discussion to be had.


Immediate aftermath of October Revolution was widespread death and famine. It was so bad that the communists introduced market capitalism again, called New Economic Policy.

The immediate aftermath of the October Revolution was actually five years of a civil war that killed ten million people, which was then capped off by a severe drought.

The 'economic system' is based on fundamentally one thing: people doing stuff. If people can't do stuff, literally, like go out of their houses, then no new economic model can work. It's like, the one requirement for everything.

this assumes the existence of magical economic systems with infinite reserves in other planets. The economy is people, its a dynamic system, it doesn't actually have reserves

“If the economic system breaks...”

No, this is people breaking. Peoples lives and livelihoods break due to this kind of economic and social strain.

And the quarantine effects everyone severely, not just 14% of people.


Ok, you can pay them money, but what are they going to BUY with that money? If people aren't working to produce things, there isn't going to be anything to buy with the money we pay people. That is how you get runaway inflation.

They don't need lots of money to buy lots of stuff. They need to keep themselves fed and keep the electricity on while they're out of work. Food and electricity are two things that will still be produced throughout any "shutdown".

> It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

The Swiss Federal Council is setting aside billions of CHF (I think the total is currently at 32 billion) for exactly this: some relief for small and medium sized businesses. They've recently announced a process to have 80% of your salary insured up to a certain high cap, between 150k and 200k CHF.

There might be vastly different political and scale differences between the USA and Switzerland that make this infeasible for the USA. But Switzerland is showing that in principle it can be done. Making your blanket statement for the whole world, false.


42 billions total now, the 32 billions just announced is on top of the 10 billions already put aside last week.

And yes with these measures essentially any income is now assured: Salaries, salaries of SMB owners (normally excluded from unemployement benefits for obvious reasons), hourly workers, limited contracts, internships/apprenticeships, self-employed (i.e. without being employed by an LLC or something else like that) business like artists. Also daily stop-gap money if you have to stay home for more than a few days to figure out how to take care of your homeschooled kids.

Plus like 20 billions in credit guarantees for small businesses to avoid a cash flow squeeze.

All measures use existing infrastructure for paymenet (commandeering the banks for the cash flow squeeze credits) to guarantee the money has arrived by end of the month, latest. And that it will continue to flow, like regular pay check.


France is having same stategy. “Chomage partiel”

> The solution is aggressive, continuous testing so that people can feel safe going back out.

I disagree, and strongly.

This would be a knee-jerk, hyberbolic, and woefully ineffective over-response.

Typical for the times.

The only thing this might achieve is creating an even greater climate of fear and loathing.

There will be false positives. And false negatives.

There are with every medical test.

Back-of-the-envelope calculation: Assuming we "test everybody", and assuming both a 5% rate for both false positives and false negatives -- which is better than we currently do with influenza testing![1] -- we would needlessly quarantine 12.5 million people, and fail to quarantine an equal number of infected carriers.

Not to mention, the data about COVID-19 is all over the map. We still know very, very little about this disease. Understanding it well enough to calculate the appropriate response will take time.

Testing is part of the solution, yes. But the economic and social impact of "test everybody, every day" would be catastrophic.

Until then, in the short term, there are things we can, and should, be doing, as individuals:

(1) Limit your physical contact with others.

(1a) Especially at-risk individuals. The elderly, young children, etc.

(2) Support your local businesses through delivery, online ordering, and gift certificates.

(3) DON'T HOARD SUPPLIES! You do not need a decade's worth of toilet paper. Three months' worth is fine.

(4) Related to the above, maybe use this as an opportunity to live a bit more sustainably.

I'm down to four sheets per wipe -- certainly fascinating, relevant, and not at all disgusting to all of our readers -- which means that a single CostCo-sized pack of TP might keep my household going for well over six months.

On that note, I'm learning to garden. Let's see if I can manage to actually grow a fucking potato this year, all I got last year was a big leafy plant with zero tubers.

A discussion on government policy in response to this is a big ball of... things that require four sheets of Kirkland Signature, so I'm so not going there.

[1] https://www.cdc.gov/flu/professionals/diagnosis/rapidlab.htm


Your logic is off. In the absence of data there is more fear because you have no idea who might possibly be sick. Once you start testing you can bring epidemiological tools online and alert people to possible exposures. If you don't do that the only sure thing is to quarantine everyone because you have no data, that will tank the economy for sure.

> Your logic is off. In the absence of data there is more fear because you have no idea who might possibly be sick.

There is a massive gap between "test everybody!" and "test nobody!"

We have a finite capacity to test. Tests have accuracy limitations. We can work within both of those limits to mitigate risk as much as possible.

Drastic times require effective measures.


> we would needlessly quarantine 12.5 million people

As opposed to needlessly quarantining 300 million people?


There is a gross difference between "quarantine" and "limit your physical contact, especially with the young and old, while we sort this out".

> ...we would needlessly quarantine 12.5 million people, and fail to quarantine an equal number of infected carriers.

Well, the failure the quarantine would be the false negative rate times the infection prevalence. A significantly smaller number than the false quarantine rate, until the whole gadonkun no longer matters.


Very true. Mine was a quick back-of-the-envelope calculation based on a highly charitable scenario.

The alternative is total economic destruction.

Interesting that almost all of your examples of "contours of infection" are places that people don't need to go to, and the last one can be replaced by teleconferencing. That makes it sound easy: if you don't want to be tested, or it's too much hassle, just don't go there!

I assume in your system that everyone would need to be tested before going to work every day, because that's the most common in-person gathering for most people. The USA has run fewer than 50,000 tests in the months since this began. Your plan would require 100,000,000 tests in the USA every day.

No need to make the test stations "mobile". You could put 1,000 in every city, and they'd never have time to be moved. Every sidewalk downtown would be lines of people waiting for a test -- which itself would be a bigger gathering for me than just going to work.


Well worth noting:

If everyone is tested, the disease can be controlled:

https://www.theguardian.com/world/2020/mar/18/scientists-say...


Not to mention it isn't really solving the virus situation in most implementations. For example, everybody is packed into the local supermarkets at the same time in my area. Not only is there higher density due to closed restaurants, but also due to reduced hours (somebody thought curfews were a good idea).

In their panic, people want "something" to be done. In a couple years, we will be talking about how 90% of policies enacted during this crisis were a net negative, and 50% of them directly made the problem worse. Not to mention the ethical concerns of legal overreach.

* Disclaimer: It's a serious situation and I do not endorse a hands-off approach. That doesn't mean we can't have a civil debate about the complexities of trying to mitigate it, though.


> For example, everybody is packed into the local supermarkets at the same time in my area.

Well in my country (Poland) with all the noise and confusion some rational procedures get implemented. Supermarkets limit strictly the number of customers inside. Cashiers get physical protection from customers. Contactless payment limits have been doubled. Etc.

So we are getting time for implementing changes and the life can start returning to 'new normal'.


> 90% of policies enacted during this crisis were a net negative

Compared to what? An exponential explosion, like what we saw in Italy, prior to the measures, but ten times worse, because you don't even do anything to check it?


Thank you, I thought I was the only that see these government measures as not only being destructive to the economy but actively make the situation worse

They are shutting down many businesses, and more or less forcing people in to situation where the virus will spread further.

the Panic in society currently right now will do more to spread this virus than anything.

But hey lets destroy our economy as well, that will do wonders to stop the panic


Leave it to HN to come up with an oversimplifying app-on-your-phone-solution to any of the world's problems.

By the time you're done developing the app, deploying "thousands of mobile test stations", figuring out a way to get test results in 15 minutes (!!!) and implementing security checkpoints at each establishment from gyms to workplaces, we'll all be infected.

> Want to get into a theme park?

Nobody cares about theme parks right now. We care about getting infected at the supermarket, or bringing infected bags home. You're missing the forest for the trees.


Unfortunately the tests can’t be replicated and distributed at anywhere near the rate that the virus can be.

It is a good idea, however it is too late to execute it well at this moment. As a society we should put incentives differently, so that things like adtech and cheap imports from China get less incentives, but health and solving social problems get more than today and can attract and retain more talent.

It would likely take longer to develop and roll out a system like that than for social distancing to run its course

> It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

Is that actually true though? What resource are we low on? Do we not have enough nonperishable goods or public funds to pay for utilities and basic infrastructure?


We might have enough food etc stockpiled, but the servicing of debt (upon which everything is built) drives a certain modest urgency through the whole system.

The need to service crushing debt is a large part of what everybody is hoping will fall away. A primary economic concern right now is people losing their homes for failing to make rent, whether they rent from a landlord or "own". Businesses will go bankrupt for much the same reason - high burn rates that were mainly just going to the banks.

Debt has metastasized and spawned many industries, so its retraction is unlikely to be a peaceful event. But it is a cancer that will kill our society some time. The only question is if now is that time, or if some patching will get the system through this and we can go back to pumping the stock market as a false idol of productivity.


Yes! That's what my comment was hinting at.

We have:

* work to be done

* people willing and able to do the work

* resources with which to do the work

So what exactly is stopping us from putting those three together?


As a point of theory, in a highly deflationary scenario the correct response may be for the government to (controllably) print paper. Given the right distribution mechanism debt could be serviced on the freshly printed paper. The effectiveness of such a strategy is dependent on how efficient the mechanism to distribute paper to end debt holders as well as how well monitored the money supply is.

The worst case on such a scenario is that an economy sits on rationing for a period of time, followed by a strong and possibly inflationary demand spike, but businesses and people's balance sheets could be partially paused.


I think it is implied that the debt is serviced via quantitative easing.

>. It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

We need to develop that capability. Imagine the next pandemic was worse, spread more asymptomatically and/or required a longer isolation time to get over without spreading combined with higher fatality rate, or fatalities in a younger demographic.

This could also help us learn how to deal with more tangentially related things like grid disruptions (hopefully we don't eliminate cash in response though as that might hurt in that scenario).


I agree with the spirit, but theme parks specifically should probably stay cancelled until the virus is completely and universally suppressed. Temperature checks in smaller public accommodations, absolutely.

> It simply isn't possible to shut down the economy and then pay people, businesses to sit idle for an undetermined amount of time.

Thinking abstractly, why not? If the businesses are open, the money is there to pay everyone. If you send everyone in the economy home, where has that money that would have been used for salary gone?

Someone is holding it rather than distributing it, that's the only reason. So, take a look at who is hoarding money like a dragon sleeping on a pile of gold, tax it, and pay everyone else enough for a roof and food.


You can easily find the person who is holding rather than distributing the money. In fact, you looked at them in the mirror this morning.

I am voluntarily (10% family-preservation, 90% community service) staying in my house. I’m now “hoarding” (to use your hyperbolic term) all the money that would normally go to fuel, eating out, and entertainment.

The restaurant, movie theater, and gas station owner would, circumstances permitting, surely prefer to be able to serve me and I likewise.

Why don’t I just mail checks to people that I’d normally buy from? Because I don’t know what my own economic future looks like. Will I have a job in 6 months? What will my retirement savings look like then? Plus, I can’t just send the money where it would have gone and also send it to the people who are now selling me more at-home food or new goods/services that I need to be productive at home.

I’m fortunate to work as a W-2 office worker/spreadsheet miner, at least for now. If I were a bar, movie theater, or auto repair shop owner or worker, I’d be in a lot worse shape.

This is not a Bezos, Gates, Musk driven problem. This is driven by the inability of the consumer to consume normally.


You could buy gift cards for future service at these bars and restaurants. The business gets cash now and you get a discount.

If they remain open. That might be about a coin-flip on average at this point.

As a moral issue, we are choosing to continue to pay our every-other-week house cleaner to not clean our house. Everyone else is getting paid iff they provide current goods/services. We have our own financial survival to look out for until more is clear about the economic outlook.


I don't know what to say.. Do you want your local food and bars to remain in business? If so you have to prepay. If you buy a gift card you are basically insuring them against default. I am sure they will factor in some loyalty reward. Restaurants and bars close and change ownership all of the time.

I mean this is what unemployment and governments are for. To insure losses in the extreme. We should have policies and procedures where a 2-4 week or month lockdown doesn’t destroy you financially. That gives the economy and people time to adjust.

Huh? An idle business can only distribute cash for so long before it runs out.

But again, follow the money. Where is that exact dollar that would have gone to that business had there not been any coronavirus?

The economy is a circular river system. If it stops one day, there is going to be areas of drought in places, as well as huge reservoirs protected by dams. Money does not disappear, it only moves. You lose money on stocks, someone else on the other side of the world made money with their short position.

Perhaps that dollar is held up in some whale's cash account after they closed their positions. You would tax that whale for that cash, and redistribute it to the working class to afford food and shelter.

In any recession, the big stall is capital being too skiddish to pay for labor, resulting in lowered consumer spending, justifying less demand for labor, and creating a worsened financial crisis due to even lower consumer spending levels. If you are able to keep the working class afloat, you can conceivably keep consumer spending afloat, and therefore keep the economy afloat, even if capital is fearful.


> The economy is a circular river system.

The economy is the collective action of people producing the goods and services that you and I consume - food, haircuts, medicine, video games. Money is a claim on some portion of that stuff that has been or will be produced. Redistributing money is not going to suddenly make us productive again when most people are only leaving their house once a week to stock up on groceries.


If the business is providing no services or products, then it cannot afford to pay its employees. This is because the economy is built around mutually beneficial exchange, which only happens when people can work.

Example: I go to a clothing store and give them an amount of money that I value less than the clothes they give me in exchange. We are both better off because we have made that mutually-beneficial exchange. If the exchange doesn't happen because the store is closed, then there is no revenue (let alone profit) to divvy up.

The only way to simulate that transaction in a way that gives money to employees is to literally take it from customers who receive nothing in return.


What I'm saying is there is still money even if it's not currently circulating. In your example, you go to the store and it's closed, the money remains in your pocket; it still exists.

My solution would be to tax you redistribute that money from your pocket to the people who need food and shelter, the same people who stimulate consumer spending, because you are unable to currently do that yourself due to shelter in place orders and/or perceptions of the state of the economy.


You are not acknowledging the core economic problem which is that the productive capacity of the economy is going to be destroyed if this doesn’t end soon.

What you are describing is essentially how to ration the dwindling supplies of goods during the epidemic.

Enacting arbitrary taxes where the government simply appropriates funds from entities that have it and gives it to those who don’t is unfair, dangerous, and will undermine trust in the rule of law. It will be ripe for abuse and predatory behavior. It is also a system that loses the critical information market mechanisms provide, instead replacing with “command” based allocation which is a dangerous precedent.

The way to achieve what you propose that is not at odds with civil society is for the government to “print” new money, and distribute it through moderately means based criteria.

The US has unlimited capacity to increase its money base as a sovereign entity. Normally this is done through the Fed buying bonds from the treasury. The treasury has the authority to create money directly if they choose.

This has the effect of devaluing the currency as a whole. By distributing the new currency ti citizens that need it, it is effectively a transfer of wealth that is distributed throughout the economy in a decentralized and proportional way.

It is only necessary to target those who need help, opposed to harder problem created when the need to target who can “afford” to sacrifice their savings is added.

This doesn’t address the problem of productivity lost, but it allows what productive output there is to be more fairly rationed.

It also less subject to being the legal and political nightmare your suggestion entails.


Where is all the stuff that we use in our day to day lives going to come from while the economy is 'paused'? Who is going to make the food, distribute the food, sell the food, drive the trucks, etc?

There are two sides of our society; production and consumption. If we aren't producing, how are we continuing to consume?


Well, there's inventory of various essential goods in a variety of places, and all the essential services you note, as well as power, plumbing, etc.

Instead of going to a restaurant, I make a sandwich, instead of buying a new shirt, etc. GDP has indeed dropped, and some people have no cash flow (fixable), but I'm not seeing physical (excluding the abstraction of the banking system) reasons why this can't be sustained for months if necessary.


No, that will not work. This virus is so infectious, one person can infect a whole bus by just coughing a few times, or the whole elevator by just breathing in an elevator. By the time he tests positive, he had infected dozens of people.

That's what happened in South Korea, as far as I understand. They missed just one guy out of 31, and he started a massive infection.

Yes, massive testing is indeed better than what we do now, but if you let people to just walk around, it will do absolutely nothing.


the test kits would be positive when it's too late to stop this highly contagious virus. PCR tests are needed, which means, every day submitting a spit sample in some collection space, and get the result at night. It's not impossible, with a lot of automation and scaling of PCR machines and huge mobilization. It could become a routine for a long time if automated.

Are you writing a “Black Mirror” episode?

Yeah, sorry buddy, I'm not going to get tested like that.

I don't think this solution is sustainable either. It takes one bad apple to restart the exponential growth rate. Look at south Korea and patient 31.

I suspect after 1 or 2 months people will say enough is enough and force their reps to call off the quarantine. We can't do this for 18 months.

And then 3 weeks later, they'll say enough is enough, and beg for it back.

There are not enough tests and it will take months and months to make them.

Also HIPPA laws prevent what you propose.


What do you base the months and months estimate on?

Worth discussing, but it would take months to deploy the level of testing required. You’d need to test a significant fraction of the entire US population every day. Say 30%, which is probably too low. So we need 100 million tests per day? That’s many months away, as is the miraculous (and privacy issue laden) database you’re talking about. By then, this will all be over and millions dead if we just let it run unchecked. We’re buying time to be able to actually implement something like that. It can’t happen in a matter of days or weeks.

Focusing on positive or negative is the wrong focus, we need to test for immunity. Those who are immune can contract the virus again in a year, but will do so without symptoms, according to older studies for similar viruses.

And most importantly, those with immunity can go on to lead a normal life and participate in the economy.

https://twitter.com/NAChristakis/status/1240689935557865472


Test everyone at onset of cold symptoms or a fever. Taking hypochondria into account it should come out to once a month. So 10 million tests per day.

People can be contagious before symptoms. And that’s also a very different strategy than testing everyone before they go into work each day. You’ll miss the vast majority of people if you just test people with symptoms.

South Korea isn’t testing everyone, every day. Neither is China.

So there’s a middle ground here somewhere.


Neither country took the middle ground compared to where the US was when we finally started reacting.

South Korea has been aggressively testing, contact chasing, and quarantining from day 1. Look at their number of tests per capita compared to ours.

China did indeed shut down the entire economy for months for provinces containing 900M people iirc. In barely hit provinces they have teams of thousands of people doing aggressive testing, contact tracing, and quarantine.


South Korea has tested 0.5% of their population by some accounts.

I mean, yes, that's great, but it's not as widespread as people are implying.


The number of new cases in South Korea has started to increase again, and they keep getting new clusters unlinked to any known cases: https://uk.reuters.com/article/uk-health-coronavirus-southko... I suspect that they're going to have to give up on the tracing and testing approach in the next few weeks.

Daily New Cases isn’t actually trending upward at this point;

https://www.worldometers.info/coronavirus/country/south-kore...

The article you linked is based on a single day’s new case count.


Stopping every transmission isn’t necessary. We just need some way to drive R < 1.

China’s approach (lots of temperature taking, testing everyone with a fever) might not eradicate the disease here, but it could keep it manageable until a vaccine is deployed.


Yes, you are the voice of reason! R of .9 is just fine. Pushing R to 0 is unnecessarily costly.

Yep, I am not totally sure what you do about it (stuff like testing people at work is going to be tricky legally) but I came to this conclusion the other day too.

The issue really isn't the virus but the fact that people who end up spreading it, don't know they have it. Shutting down the economy is a backwards way of solving this...it is assuming that everyone has it.

I am not sure how exactly we get to that point and you are kind of hoping that people who have it isolate...but testing really should be priority. My govt is ramping up but the numbers they are talking about are still ludicrously small...total tested is 0.1% of population, and they are saying it is a resource issue (whilst they are spending literally hundreds of billions on stuff that is being caused by their testing strategy).


One thing that really horrified me was how quickly people threw away the economy.

Unfortunately, this virus is highly contagious (to the point that the vast majority of countries won’t contain it) and fairly lethal. We don’t actually know how lethal, but it appears 1%-3%, but without widespread testing we wouldn’t know.

At the moment, we just reduced our GDP by 30%-50% in regions under quarantine. Think about that for a second...

Now consider the fact that the supply chain is also all kinds of messed up and with the loss of jobs people have less money.

Finally, save this, but I don’t think the US quarantine is going to do much to lower the curve. Simply put, the west is not prepared. Our checkouts are run by people without masks or gloves. People still are closer than 2 meters (or 6 feet).

To lower the curve we’d need strict quarantine (no leaving the house) for a month or two. Even then we won’t have enough masks, hopefully we’d have enough ventilators and tests by then...

Point is, we are tanking our economy and mark my words — it won’t work. People voted, had spring break, celebrated st. Patrick’s day went out shopping in droves. It’s likely too late, one sick per household and they infect the whole house.

All this to say: we are losing our economy and probably this isn’t effective.


New Yorker here. From what I see through my window, my fellow New Yorkers still don’t “get it”. I see clusters of people hanging out and families going for leisurely walks. If this keeps up the number of infections - and deaths - will only increase.

Last week my brother suggested instead of working from home I work from a Starbucks.

I feel like people don’t understand how serious this is and it’s really bothering me.


There's nothing wrong with people that are living together going for a walk together, it won't particularly increase their exposure.

People should cooperate and keep distance, but it's not a big deal to just be outside a reasonable distance from small numbers of other people.


Something that amused me the other day was was an NPR reporter saying, "I went to the park yesterday and I was surprised at all the people just out in the park" as if they didn't also make the choice to go to the park.

I feel this. Every time I go out (to the park) I’m amazed at how many people are out. I start thinking about how we’re doomed, because people obviously aren’t taking this seriously. I mean, they’re at the park instead of huddled in their apartment!

Then I remember I’m at the park too...


> There's nothing wrong with people that are living together going for a walk together, it won't particularly increase their exposure.

And it might help to keep them from going stir crazy from being cooped up inside too long...


I'm more sanguine. I live on a busy Brooklyn street which is normally packed with people shoulder to shoulder during the day, and I will see maybe 5-10 people on the block at what should be the busiest time. I think it's like a 90%-95% reduction which is certainly substantial enough to quench the spread enough to reduce the shock hospitals are receiving.

Doing my part (I have asthma), I haven't left the apartment since Sunday :^)


But for how long? The stricter the quarantine the longer we have to quarantine to reduce spread. That's the problem. Best estimate is we can reduce daily interactions by 70%, for the next 12-18 months.

The alternative is systemic failure of the healthcare infrastructure and millions of deaths.

We don't know all the alternatives yet.

The exponential function is a terrifying beast. Any alternatives we don't know now are irrelevant. There is a reason why NYC is bracing for impact: a tsunami of new cases are about to slam into the healthcare system.

Usually Hacker News middlebrow skepticism is just in poor taste. On this topic, it is foolish and farcical. One of our doctor friends is already telling us that her hospital is under stress and she's not in one of the hardest hit states.


I'm not sure we want to find out

> which is certainly substantial enough to quench the spread enough to reduce the shock hospitals are receiving.

You absolutely do not know that and should not be saying any such thing with confidence!!!


I did not say eliminate the shock. I said reduce the shock. Epidemiological reports support the hypothesis that this level of social distancing is effective to reduce r. When exponential functions are involved, even small improvements pay off big in the long run.

You obviously don't have young kids. Leaving your apartment and taking them for a walk is the bare minimum to the whole family not going crazy during something like this. You can't just sit at home and chill like a single adult can.

Not without a Wuhan-Style lockdown, apparently.

Quality of life in China is not all it's cracked up to be.

Leisurely family walks are fine.

Generally, clusters are OK for people that live together anyway.


Hmm, I think NY still 'gets it' much more than Tokyo, just see for yourself:

Shibuya Crossing: https://www.youtube.com/watch?v=0vishEDtgdw Times Square: https://www.youtube.com/watch?v=mRe-514tGMg


Nowhere have you seen numbers that remotely approach 1-3%.

You’ve seen the critical, largely elderly population get tested and from that you get that number that’s freaking people out.

Stop spreading panic. With those kinds of numbers China alone would have 10M+ dead. In Japan, Singapore, surrounding nations more millions dead.

Use a bit more common sense. We know we haven’t tested enough in the US, yet we don’t have bodies piling up on the street. You don’t have families of 4 where 2 suddenly die. This has been going on for greater than 3 months now.

Stop spreading fear. The only thing to fear is the terrible consequences of those stuck inside the fear bubble


4 dead and 3 more in critical condition from a single family: https://www.nbcnews.com/news/us-news/coronavirus-shatters-ne...

26 dead at the washington nursing home, 50 tested positive: https://www.businessinsider.com/coronavirus-deaths-washingto...

Death rates by preexisting condition: https://img.buzzfeed.com/buzzfeed-static/static/2020-03/13/2...

America has 42% obesity rate and a huge population with diabetes and heart issues, the numbers for 30-60 year olds might end up looking a lot worse than in Asia and Europe.


Question for OP: does this data change your mind? If not, what would?

Zombies.

I think a zombie outbreak would be much easier to handle, at least in the US.

It would probably be much easier to see who is infected, and thus "eliminate" the problem. In the US, there are plenty of bullets and guns everywhere.


That it impacted the kids and 20-30 yo cohort the way it impacts the 70+ yo.

Also those co-morbidities like high blood pressure have the all important age distinction missing. So yeah if you’re 70 and have high blood pressure it’s worse.

It’s perverse to stop world for some low rate CFR for the elderly. The world is made for the young. We shouldn’t destroy it for the elderly.

Also actuarial tables for a 75 year old is extremely haunting. People magically forget that a sick 75 year old doesn’t have much time left to live in the first place.


This is a bit disturbing. We should what, just let the old people die (or at least ~10% of them)?

Where did you get 10% from?

We should treat them as best as possible but not by stopping the world.

Look up the actuarial tables for a 70 year old. Living another year is significantly different than for a 45 year old.

Then lookup the survival rates for a 70 year old with influenza, suddenly the numbers keeping you up at night start looking weak in comparison.


Numbers vary a bit but looks like death rate of confirmed cases of covid 19 for 70-79 year olds is 8% and over 80 is something like 14%.

Flu varies by season but it’s no where near that for the same age group.


When the hospitals are full of covid victims, all demographics will suffer, as you will not be able to receive care for your non-covid related ailment.

The 1-3% is an average among all age groups. You clearly have not looked at the data. For example, in Italy the CFR is somewhere around 14% for elderly. Everyone else is lower such that the nominal death rate, being an average among all groups,.has been consistently running around 8%.

Obviously when this matures that rate will go lower because the denominator will grow but the denominator that people care about is the one we have now: who is sick enough to need a test because if I get sick, and thus become part of that denominator, the current rate gives me a good picture of my chances. Was the parent comment slightly hyperbolic, maybe. But you are way underselling the seriousness of this disease and the rationality of being scared of it.

whb07 9 days ago [flagged]

Holy cow. Notice how everyone literally says “there’s not enough testing” but yet you’re able to rationalize the CFR as valid.

What you see going to the hospital and getting tested CLEARLY is the most critical number of cases. It’s possible that for every person tested, there are 100 or more that are asymptomatic. Run some numbers on this “highly contagious” disease.

Another point why we are in a fear bubble is that everyone parrots the same fear gospel and there’s very few dissenters.

Bring on the downvotes you scared folks


WHO assistant director general & epidemiologist Bruce Aylward's investigation in China found that there wasn't a significant 'iceberg.' There's other supporting data elsewhere. I find these three paragraphs easy to digest:

-- " In Guangdong province, for example, there were 320,000 tests done in people coming to fever clinics, outpatient clinics. And at the peak of the outbreak, 0.47 percent of those tests were positive. People keep saying [the cases are the] tip of the iceberg. But we couldn’t find that. We found there’s a lot of people who are cases, a lot of close contacts — but not a lot of asymptomatic circulation of this virus in the bigger population. And that’s different from flu. In flu, you’ll find this virus right through the child population, right through blood samples of 20 to 40 percent of the population.

If you didn’t find the “iceberg” of mild cases in China, what does it say about how deadly the virus is — the case fatality rate?

It says you’re probably not way off. The average case fatality rate is 3.8 percent in China, but a lot of that is driven by the early epidemic in Wuhan where numbers were higher. If you look outside of Hubei province [where Wuhan is], the case fatality rate is just under 1 percent now. I would not quote that as the number. That’s the mortality in China — and they find cases fast, get them isolated, in treatment, and supported early. Second thing they do is ventilate dozens in the average hospital; they use extracorporeal membrane oxygenation [removing blood from a person’s body and oxygenating their red blood cells] when ventilation doesn’t work. This is sophisticated health care. They have a survival rate for this disease I would not extrapolate to the rest of the world. What you’ve seen in Italy and Iran is that a lot of people are dying. "

https://www.vox.com/2020/3/2/21161067/coronavirus-covid19-ch...


There can be a wide range of assumption. Anywhere from "all the people we know about are all that are infected" to "everyone else in the world is already infected".

Regardless, the death tolls kind of speak for themselves. What's more, the increase in death toll too. In Italy alone there are over 4000 dead, with a few hundred more a day now. Italy has a population of 60 million. Extrapolating even the current death count in Italy to the rest of the world, and that's 400k deaths. All indications are that it'll be higher than that uncontrolled.

Maybe people are overreacting. But in this case isn't it better to error on the side of caution? Otherwise by the time we realize we're wrong and millions are dying, what do we do then?


I’ll give you a couple reasons why Italy is the mess it is:

1. Significantly older population

2. Shitty healthcare

For context many years ago, the state of Ohio in the US had more MRI machines than all of Canada combined. It’s very possible that due to budget constraints and other things, they have terrible health infrastructure.

Why do we believe that all nations are equal? I can take a look at the Olympics and notice that isn’t the case. Italians make better cars as compared to the French. So maybe they have terrible elderly healthcare? That seems more likely than “super disease kills only Italians and now comes after Americans”


As I understand it, one of the first cities in Italy to have problems keeping up with healthcare .... has some of the best health care in Europe.

There is no treatment other than providing ventilation to the very sick.

There's at least two therapeutic candidates: chloroquine and remdesivir. See: https://wattsupwiththat.com/2020/03/20/wuhan-coronavirus-the...

I already answered this in a sister comment. There are at least 3 candidates (Chloroquine , Remdesivir, Favipiravir ) and they are all unlikely to work.

Follow the article and read the summary, remdesivir was already trialed on a patient in Seattle: "The patient had visited Wuhan, returned to Seattle, began displaying symptoms, and was hospitalized on symptom day 3. By symptom day 8 X-ray showed clear lower respiratory tract viral pneumonia (diagnostic ‘ground glass’) and supplemental oxygen was started. Patient worsened, and intravenous antibiotics were started day 9. Patient worsened (proving viral pneumonia), so attending physicians consulted with FDA then had Gilead rush the experimental drug by air, with intravenous treatment starting day 10. Patient improved in 24 hours, was saved, and has since been discharged"

Importantly, "It did, however, show efficacy against SARS and MERS in vitro" So the drug is promising. Not saying it's a silver bullet but definitely promising.


Yes there are some possible treatments and a number of vaccines are already being studied now.

Vaccines are at least a year away. In order of most to least likely to work:

1. Chloroquine is hepotoxic and since cytokine storms is already one of the way covid19 leads to death there is a lot of question whether chloroquine can actually help (in terms of aggregate effect on CFR).

2. Remdesivir didn't work for ebola (original target) and there is no reason to think it would work for covid19.

3. Favipiravir shows activity against many viruses (SARS-CoV-2 included), but doesn't actually reduce mortality for other viral illnesses (unknown for convid19).

Key to understand, many things show activity with the virus but don't actually improve the disease progression.


If there are 100 or more asymptomatic and untested cases per tested case, then the disease is very highly contagious, given the timeframe we're looking at.

Its 1-3% of confirmed infected, not of the population as a whole or the quarantined area. That 1-3% varies in terms of age and other comorbid factors.

China would have had those numbers if they didn’t quarantine a whole region for 3 months.

They may still have those numbers after they lift the quarantine.


Quick now do the same for the 50 other countries nearby. What was their reason?

Fear now is better than horror when the healthcare system collapses.

As a counterpoint, Illinois just ordered residents to shelter-in-place after closing schools and restaurants a week ago and our new cases of COVID-19 aren't accelerating upward as of today. This model also predicts far fewer deaths with shelter-in-place rules: https://covidactnow.org/state/IL

As governor Pritzker said: "I fully recognize I am choosing between saving people's lives and saving people's livelihoods, but ultimately you can't have a livelihood if you don't have a life."


It should take quite a while (several weeks) to see the effects of any actions. Anyone who just caught it has a bit of time Before it gets severe.

Roughly a minimum of 10 days; 5 days for symptoms to appear, 5 days for tests to come back from those showing symptoms.

I more or less agree with a temporary shut down however I see the quote all the time, and it is a stupid statement, because you equally can not have a life with out a livelihood

This the the doctors delima, that does not factor in quality of life in to the "life" equation, life with no quality is not much of a life.

Further I have big problems with the Governer or the government making that choice, it should not be the government choice of my livelihood over my life, in either direction. No only is it shocking how fast people willing toss the economy aside and expect government checks to save them, it is also shocking how fast people simply toss aside all civil liberties.


I generally agree. That said, we tried the personal responsibility route, and then the bars packed up for St. Patrick's day and the airports ended up becoming giant petri dishes - literally overnight. And then many, many, many people decided that "don't panic" meant somewhere between clear all the shelves at every store and ignore the problem until it goes away.

I don't envy the local governments trying to contain this with almost no data and no help or direction from the federal government.


Well I am equally not sure why it is federal governments responsibility to help and direct

In our system of government the State Governments are suppose to be the most powerful, not the federal government

it is a Union of States after all.

The fact that in the last 100 years or so we continually have centralized more and more power into the hands of the federal government is a huge issue, but instead of recognizing that issue people seeming want to put more and more power federally and continue to strip their local governments of power

The smaller the unit of power the faster it can react to local changes. In situations like this it SHOULD be local government leading the charge not a slow monolithic federal government


That's fair, but this is exactly the sort of issue that needs to be orchestrated at a higher level. If Illinois handles this perectly somehow, but the surrounding states do not, then Illinois' efforts will be wasted and overcome by the neighbors. There's no way this sort of problem will be resolved without the entire country being on the same page for the solution. That's exactly the sort of thing the federal government is good for.

I am pretty sure we are going to disagree widely was to what "sorted out the problem" looks like in execution

Especially if you think Illinois is a model everyone should be following


I'm pretty sure you're aware that was hypothetical.

If this was done from the start then we could have recovered from it much easier. We should have never waited when we saw this was the road every other country was clearly going down and they handling the situation better than the US before the shut downs.

The problem will be how long the shelter in place can be maintained; as long as you have folks coming in infected from other states, once the mass quarantine is lifted, outbreaks will flare up.

This only ends with a vaccine and enough people recovered after infection we arrive near enough herd immunity. Until then this will have to burn through populations. Regardless, I can appreciate and support Pritzker’s response, and efforts to “flatten the curve”. It’s an unfortunate situation with no clear path to success.


I agree with your first paragraph. On the second, I would think a moderately successful therapeutic protocol would go a long way to quickly getting us out of the houses. A vaccine is too long a time away to count on; there won’t be an economy left by then.

We don’t have a vaccine for the common cold, not for lack of trying. AFAIK we’ve never made a vaccine for a coronavirus. This isn’t the time to be relying on silver bullets.

Common cold is caused by hundreds of different viruses so a single vaccine is not useful

Similarly, this one is mutating pretty quickly: https://www.medpagetoday.com/infectiousdisease/covid19/85500...

Cases are lagging apparently, peaking at two weeks after the initiation of a lockdown.

It takes two weeks for symptoms to show up.

Ok, so where are the cases from 2 weeks ago?

In Michigan (where I live and so am paying attention), there were 80 positive tests reported as of Wednesday and there are now 549 positive tests reported.

The cases from 2 weeks ago are seeking medical care.

I'm slightly optimistic, testing has ramped up the last few days with a large spike instead of an unimaginable one, and we will get a clearer picture as they start broadening the criteria.


I don't think the options are have a lockdown vs have a functioning economy and a bunch of sick people. Once hospitals start overflowing with this, you're not going to have a functioning economy anyway.

If hospitals can get the supplies they need, and testing and health department capacity is there to do contact tracing, the lockdowns can loosen, and our economy can start back up. Bonus points if the warmer weather in the coming months helps fight the virus.


>Once hospitals start overflowing with this, you're not going to have a functioning economy anyway.

Is this true though? I'm not trying to be insensitive, but according to reports, ~15% of the infected need hospitalization, and the distribution of those people are mostly over 60[0]. Is having these people hospitalized on a large scale more detrimental to the economy than shutting everything down? Serious question.

0. https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm


If they're all sick at the same time hospitals can't help them or anyone else. Then routine emergencies for everyone became fatal or life altering events.

Yes, it would. King County WA (where I live) has around 2 million people. Assuming half of that get infected and 15% require hospitalization. That's 150k people flooding the hospitals. That is way WAY above what the hospitals can handle. And I'm not only talking about beds and ventilators. Think about road accidents or coronaries which happen at a known steady pace when it's business as usual. These cases require ambulances and quick response times which cannot be met anymore because the system is overloaded with covid-19 patients. What do you do? Turn the 60+ patients away?

Ok, so hospitals are going to be a mess, which causes all sorts of extra problems (routine issues become really bad, etc).

But also, if there's enough people sick enough to overwhelm the hospitals, your average workplace is going to have a bunch of people out sick, and that's going to be an issue. Plus, like everybody who is well is going to be out for the funerals of the old people.

Part of the reason my kid's school shut down before they were compelled to was that they were having trouble with staffing, because staff were sick or in the vulnerable groups. No school means less workers for other jobs too.


The vast majority of people with COVID do not end up at the hospital. So it is absolute fact that we are sacrificing the economy in order to save, relatively speaking, a select few.

If this continues for more than a few weeks - 50% of American business dies. 50% of America is unemployed. Contagion from massive defaults and write-offs spreads throughout the entire economy. Money printing at a rate heretofore unimaginable and probably hyperinflation to follow.

It is no less than committing hari-kari in a moral panic. Hopefully we will wake up from the fever dream before it’s too late.

“Flatten the curve” is a terrible lie. The extent and duration of the measures required would bankrupt 95% of the country.

ICUs being overrun is actually an argument for getting the COVID cases out of the way quickly, not dragging it out over, say, 24 months.

If you can get your head around the scale involved, if 80% of people are going to be infected and 14% of those are going to need serious treatment (doubtful, but the same assumption the “flatten” exercise is based on), there is actually no way to keep COVID cases “at or below” ICU capacity. They will absolutely take 100% of capacity and beyond for more than a year, if you drag it out.

The longer you have COVID cases overwhelming your system, the longer you have non-COVID routine emergencies getting untreated.

Either you can contain it in a few weeks or you have to let it burn through. There is no “slow smolder” scenario I can see that leaves society intact.


[flagged]


I stand by every comment I’ve made. None of which included personal attacks. Most of which included citations.

Your personal attack is entirely inappropriate. I suggest perhaps it’s you that should take a break from the discussion.

As we can see just looking at how different countries have responded, there is a wide spectrum of responses, and countries have been successful getting R0 below 1 with different approaches other than total shutdown.

Even the Imperial College report notes that there are no easy choices here;

> We do not consider the ethical or economic implications of either strategy here, except to note that there is no easy policy decision to be made. Suppression, while successful to date in China and South Korea, carries with it enormous social and economic costs which may themselves have significant impact on health and well-being in the short and longer-term.

It’s crucial to note that there cannot be population health without economic health. It is not a choice between shutting down to save lives versus keeping the economy running and costing lives.

Computational Biologist Francois Balloux (Director of UGI at UCL) raises the point;

> The covid-19 pandemic is not just an epidemiological problem. It is a ‘Global Health’ problem, that can only be tackled with an integrated and global approach. For example, there is no such thing as a choice between managing the pandemic vs. protecting the economy. (11/12)

> Health and the economy are closely linked. The correlation between per-capita GDP and health (life expectancy) is essentially perfect. If the covid-19 pandemic leads to a global economy collapse, many more lives will be lost than covid-19 would ever be able to claim. (12/12)

https://twitter.com/ballouxfrancois/status/12388371731111403...


I stand by every comment I’ve made.

I’m not the least bit surprised.

Yes, my attack is personal, in the sense that it’s aimed directly at you and your reckless disregard for people’s lives. You’re spreading dangerous and false ideas in the face of a global pandemic, ideas that will cost tens of millions of lives if people take them seriously. There’s no reason anyone should listen to you, since you have no expertise, you’ve been wrong about everything all along, and you continue to disagree with the experts, as you have all along.

But like you said, you stand by every statement you’ve made.


Please stop posting flamewar comments to HN. We ban accounts that do that, regardless of how wrong the other person is or you feel they are. You owe this community better if you're posting here, particularly now, when stress, fear, and anger are at higher than normal levels, and nobody knows exactly what is happening.

https://news.ycombinator.com/newsguidelines.html

Edit: unfortunately, it turns out that you've been doing this so much that I've banned your account (https://news.ycombinator.com/item?id=22659159). Please don't create accounts to break HN's guidelines with.

zaroth 7 days ago [flagged]

I stand with the experts that I’ve been citing. You should log off if you can’t maintain civil discourse.

You couldn’t be more wrong with your accusations, and I will continue to lend my perspective to this debate with a slant toward long-term macroeconomic thinking that I believe is essential in managing a global health crisis, and saving the most lives long-term.


Except the experts have disagreed with you from the start. You think we’re shutting down countries all over the globe against the advice of public health officials? Or even economists?

I have no doubt you can produce a “citation” of someone that agrees with you, especially if you twist their words to support your point. But you’re not seeking the truth, you made up your mind a long time, which is why the vast majority of experts disagree with you.

And I have zero doubt that you lack the shame and introspection to stop posting now, about something you know nothing about and have been wrong about all along. You should be ashamed though, you’re part of a movement costing lives. And I won’t be “civil” while you do so.



Why won't you have a functioning economy? How long did the effect of Spanish flu on the economy last? And that one mostly killed young people.

“one sick per household and they infect the whole house“

This happened repeatedly in China; in fact, the nature of a lockdown sort of encourages this. But an infected household of 5 ppl is significantly easier to contain than 1 infected person going on to infect 4 people from 4 different walks of life.


The same-household infection rate in china was 10.5% last I read. I don't know if there's any data yet from other countries.

Well, in California:

I got my groceries from people wearing masks. Everybody in the store kept 6 feet distance.

I've been working from home for 2 weeks and will continue to do so for at least 3 more. Company wide mandate.

Almost every business other than groceries/other essentials (where some are surprisingly "essential", granted) are closed so people have no reason to break quarantine except to perform essential tasks. So overall, I'd say we are doing exactly what we need to be doing. Hopefully the rest of the country follows suit


So let's cancel any sort of response, as you propose. What do the next two weeks, two months, etc. look like? I think it's the human condition to least try, but I can entertain the reality that some Americans just aren't for social distancing and of that segment, some will become superspreaders.

They should be charged and prosecuted for putting others in danger.

I wouldn't say it's lethal, at least not for everyone. The last report from Italy has stats on 2000 deaths. No deaths under age of 30 and only a few under 50, all with pre-existing health conditions. Women's median age close to 84. Men's 80. And vast majority of deaths are people with multiple pre-existing health conditions.

It could be because the application of medical care is skewed towards the young, such that they survive and those older or with less chance of surviving die. If you can reduce the demand on hospital services, then you might have enough resources to treat those high mortality cases, and under those circumstances they may survive.

42% of Americans are obese, this will hit us a lot harder than Europe.

Do you have any data to indicate that obese young people are significantly more at risk of dying than healthier individuals?


It's not like obesity isn't a problem in Europe, too. 25% is lower than 42%, sure, but it's still a lot.

We have way more morbidly obese people though http://ncdrisc.org/morbid-obesity-population-bubble.html

Reasonable compliance with social distancing from 25% of the population has a huge impact on the slope of the curve.

Of course better compliance from larger numbers of people has even more impact, but it's not a binary condition.

That said, we probably aren't doing enough to prevent hospitals from being overwhelmed, or to even push that very far into the future.


Not enough, all the simulations show we’d need to basically reduce our number of interactions a day by 75% and double the number of ventilators by 100% to “stay under the curve” that’s if we didn’t have a huge number of celebrations and people in lines, etc.

Projections are 500k dead by June. Maybe with the precautions we can slow the millions dead by the end of the year. It remains to be seen.


I mean, italy is no longer exponential, China clearly contained their issues. The doom and gloom is somewhat overblown.

https://www.worldometers.info/coronavirus/country/italy/

Looks fairly exponential to me. (log y axis) And that's just confirmed cases.


Try to fit it. More easier is to look at daily new cases. For past 4 days they are increasing linearly (meaning total is quadratic)

You have a point. We should have been aggressively testing at the start. Imagine if we had thrown the same amount of effort and money into initial testing as we are economic relief now. We'd still be open for business! But our leadership failed. So, now we have to lock down, but we should be doing it 100%. Hard core. Lock down. This weak half measure of "recommended guidelines" and leaving it up to local governments to adopt them is undermining the entire effort. It's tanking the economy AND not going to work. Let's swallow the damn pill and get it over with! Why is our leadership intent on dragging this out as long as possible? We should have been in hardcore, national lock down mode last Monday.

We'll come around, once it's too late. "Americans will always do the right thing — after exhausting all the alternatives."


> People voted, had spring break, celebrated st. Patrick’s day

Sounds a lot like Philly' Spanish flu parade,[1] as compared to St. Louis' lockdown during the same.[2]

[1] https://finance.yahoo.com/news/chart-1918-spanish-flu-shows-...

[2] https://media.zenfs.com/en-US/quartz.com/df26ee36f79f85f57ad...


> We don’t actually know how lethal, but it appears 1%-3%, but without widespread testing we wouldn’t know.

That’s the fatality rate within a functioning medical system. It’s safe to assume that if the virus is uncontrolled the rate will be substantially higher.


Why? There wasn't enough testing/medical capacity for at least the first month in Wuhan, and the rate wasn't any higher.

Well we can look at Italy for example. Also America has a lot of obese people, which are supposedly at a high risk, so it’s possible we see a higher fatality rate. I personally don’t think so just trying to answer your question

We don't know the total number of infections in Italy so we can't get a meaningful estimate from there.

Meneghini and Gram Pedersen of University of Padova just extended the standard “SIR” epidemiology model with quarantine and it has the nice property of being able to estimate the infections from the observables. Preprint on Researchgate: “ Quantifying undetected COVID-19 cases and effects of containment measures in Italy”

Sure, but if what you say is accurate, it wouldn't matter. Once people started dying by the thousand, even if they're all old, governments would be forced to lock stuff down. And even if they didn't, the economy would be hosed.

Even if you take an extremely high estimate of the currently infected in the US, you're probably in the low 100s of thousands of people, approx <0.1% of the country. So to say it's "likely too late" is just crazy - 99.9% of the country is not yet infected.

More can definitely be done with enforcing quarantine. In LA, meat is still prepared and served openly on the side of the road, so long as you have a relatively trivial permit. Even though the state is 'locked down,' you are still free to venture out at your leisure. Technically bars are supposed to be closed, but there is a pervasive speakeasy culture that hasn't slowed down.

The most vulnerable groups, the working class that pack like sardines in public transit every day, either continue work or are laid off. Tenement conditions still exist in Los Angeles, with multiple families cramming into a 1br apartment.

Quarantine is really only affecting the knowledge workers who make up a minority of the population, and who interact with a sliver of the population to begin with. Effective quarantine would include protections for the working class, but there isn't any political will.

I'm legitimately fearful of hitting the breaking point. Maybe some would call it overblown, or hysteria, but this is a city that endured three days of looting after a verdict, requiring the national guard to stabilize the situation. Men with rifles used to take positions on the roof of my grocery store. This isn't ancient history, unfortunately, it's who we are when pushed past our limits with nothing left to lose.


"All this to say: I think we are losing our economy and I think probably this isn’t effective."

Fixed this for you.

(Additional comment: I will counter with I'm really amazed how quickly people threw away the economy in an effort to reduce lost lives. Normally, I expect people to be much more mercurial)


Well, only one way to find out, right?

Masks and gloves are ineffective for people who don't know how to use them -- wearing a mask? Great. Now you just felt hot and pulled the mask down onto your chin. Congratulations, the outside of the mask is no longer sterile. You're wearing gloves? Fabulous. Now you're out shopping pushing a cart and you just scratched your nose with your gloves. Cart handle is now contaminated or visa versa and gloves didn't change anything. PPE is only effective under very controlled environments, and the general population doesn't understand this.

The economy will recover, especially since EVERY country is taking a hit, I don't think it will take very long for the capitalist engine to roar back to life. That's the beauty about capitalism -- you're turning the ingenuity of humans loose to be productive. As humans we're great at figuring out how to be productive.


The effectiveness doesn't need to be perfect. If I'm now only 50% less contagious to others with my no-longer-sterile mask, that's a huge win.

There is a shortage of masks and other PPE because people think that way. There is a cost because if everyone were to wear masks, there is not enough supply for healthcare professionals who could actually benefit from them.

The percentage of effectiveness isn't really measurable if the standard isn't followed. You're assuming its 50%, but it very well could be 0% because your equipment is just as contaminated as your hands. So you have not helped yourself, AND you have decreased supply of essential equipment from someone who ACTUALLY needs it. That's a big fail.


I agree that we shouldn't be taking the supply away from the professionals while there's a shortage, but your statement was that they were ineffective in the hands of laymen, and I don't think that's true.

I'm not assuming that they are 50% effective either, I pulled the 50% number out of my ass, but so is your 0%, and I find it hard to imagine a physical reality where me keeping a 6 feet distance to an infected person decreases my infection probability significantly more than that person wearing a mask. Anecdotally, South Korea, Japan, Hong Kong, and Taiwan, where wearing masks is quite commonplace all seem to be doing better in transmission rate than the Western world, and all that without killing their economies. And considering that we're producing around 2 billion disposable plastic bottles a day, I'd currently bet money that we should be able to ramp up the supply of cheap masks for a sum that's a lot less than that of halting 50% of the Western economy for several months. Obviously, it can't happen in a day, but I'm not really seeing anyone try, except for perhaps Trump after his recent epiphany that Corona is not a Democrats' hoax. I'm willing to be dissuaded by someone who's actually thought it through, but sadly I haven't seen any such analyses.


I'm not an expert on infection control, but I work closely with people who either work in the infection control department of a hospital, or are running their own infection prevention and control consultancy. They live and breathe this, and I am only repeating almost verbatim what they have explained to me. I'm pretty sure they have "thought this through".

So believe what you want, but I'm gonna go with the experts on this, not someone who's only support is his own conjecture lol. They're not even the only ones saying this. Go Google some reputable sources yourself and stop guessing.


Your dismissive tone is uncalled for and not appreciated. Here's a systematic review that cites several studies that find face masks show a statistically significant effect in protection against influenza:

https://www.bmj.com/content/339/bmj.b3675.short

If your collaborators can point you to peer-reviewed studies that rebut these results, or to a serious current analysis that shows the impossibility (or estimates the price and time frame) of ramping up PPE production, please post it.


> I'm willing to be dissuaded by someone who's actually thought it through, but sadly I haven't seen any such analyses.

Dismissive tone? Take a look in the mirror pal. I'm done.


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