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Update to L.A.'s stay-at-home orders (latimes.com)
211 points by CPLX 21 days ago | hide | past | web | favorite | 389 comments




I guess I will be the "Did you read the article?" guy because most of the people in the comments here are really overreacting to what was said in the article. This isn't a plan to maintain a full lockdown for the next 3 months. It was simply a comment that the stay-at-home orders are unlikely to be completely gone in three months. It is talking about the return to semi-normal life. It isn't saying all non-essential businesses need to be closed for the next 3 months. LA County has already moved to start opening up and this article says they will continue on that path.


I just don't buy it. If they were aiming to return to semi-normal life, they'd announce we're transitioning away from "stay at home". It seems very much like they're aiming to open up the bare minimum amount required to avoid riots or economic collapse, and people will continue to be ordered to stay at home.


What is the difference between your take and the parent take? All I see is you assuming a negative - but not fully described - motive of preferring to keep people at home even if there wasn't a virus out there?

> “Our hope is that by using the data, we’d be able to slowly lift restrictions over the next three months,”

vs

>aiming to open up the bare minimum amount required to avoid riots or economic collapse

why do you believe the root goal is "keep people at home" vs "respond to a disease?"


I don't think it's a versus. I acknowledge that "keep people at home forever" is a disease response measure, not some evil plan they cooked up for no reason. But the fact that they have a reason does not make it an acceptable measure.

It's especially frustrating because I've repeatedly seen people argue that it's a strawman, that nobody's really planning to stay at home forever. Even in this comments section, about an article where LA county says "yeah we're staying at home for the next 3 months at least", people insist they didn't mean it!


Do you live here? The article certainly mentions that there is already a slow opening occurring. The issue is a lack of trust or faith in the gov't to do that at a good enough pace, or to even do it correctly at all. The angst you are feeling from the comments is from people who live here.


Yes, I live in LA county and I understand the angst, but I think it is overboard to claim that residents are going to riot because they won't be able to go to a crowded bar in June.


>residents are going to riot because they won't be able to go to a crowded bar in June

I hate this juvenile, dismissive angle that's so pervasive here. There are serious considerations here. It's not just about enjoying life. First: how are we going to fund compulsory unemployment for another 3 months?


> It's not just about enjoying life.

Even so, this is not something anyone should apologize over.

Life should be worth living. To someone who has lived their whole life being able to enjoy life in any which way is experiencing a massive shock right now. Of course people want to be able to go to crowded bars, be around other people, go to concerts, ride roller coasters, get wasted, etc. We rely on these things because life is boring at best and usually bad for a lot of people. If we don't have anything to look forward to, even simple things, we lose hope. Gee, I'm really sorry that it seems selfish or even "conservative" to the smarty pants who are content living indoors and consuming media and frozen dinners. Most of us get tired of that and it becomes frightening when our jobs are in question or have no job at all. Just being able to go to a crowded bar, be around other people, having a pint, and not having to wear masks, sounds really damned good right now.

I understand that there's always a cost benefit analysis to all of this, but the high and mighty attitude towards people who simply want to feel happy needs to stop. It damages every discussion.

EDIT: Many of the people who make that kind of argument also say "cry me a river" when someone whose business or job is "nonessential" says anything negative about their predicament. Um, you people ought to look at your own jobs and question just how "essential" they are. I don't think I've ever worked an "essential" job in my life, yet I'm payed much more than most "essential" workers are.


>"I understand that there's always a cost benefit analysis to all of this, but the high and mighty attitude towards people who simply want to feel happy needs to stop. It damages every discussion."

Everyone wants to simply feel happy. Everyone is sick and tired of all of this. Everyone wants to go out to a bar and have a pint. But we can't. We just can't. And not because the government says so. But because many many many more people than necessary will die if we do. That's the reality we live in now. And not understanding that, while acting as if your feelings matter more than others' lives makes you sound like a spoiled child. That is what people are being "high and mighty" about.


> But we can't. We just can't.

Yes, actually, we can. We can reopen things like this with caution, some new social precautions, protect those who are vulnerable, and calculatingly reevaluate the risk once it turns out that the situation has become more or less safe.

This idea that we "can't" is simply bogus and based on nothing. And the idea that people, who don't put the same weight on the risks the way that you do, are being childish, is asinine. People with your position might sound like they're the adults in the room, but a policy that is more rigorous is not necessarily the better policy.

> And not understanding that, while acting as if your feelings matter more than others' lives makes you sound like a spoiled child.

Clearly, I'm a spoiled little child who doesn't care about the lives of others. /s

How would you like it if we made the stay-at-home orders permanent, decreased the speed limits to 25 MPH, and banned all drugs and alcohol, and put strict limits on added sugar and fat? After all, we could save tens if not hundreds of thousands of lives if we all just sacrificed our productivity and happiness. If we're going to apply your argument towards a single virus, why not go all the way?

Even if you were to say yes, the vast majority of people don't actually want that because this idea that we're all supposed to stay alive is a relatively new idea and, in order to accomplish it, requires a lot of sacrifice. We don't want to live this way forever, even if it makes sense from a utilitarian standpoint. There is nothing wrong with accepting that a percentage of people are always going to die. This is not spoiled or childish.


> But we can't. We just can't. That's the reality we live in now. Many many many more people than necessary will die if we do.

You aren't using the word "can" in its meaning related to ability. You are making value judgement with respect to your perceived results of doing vs. not doing something. When you say "we can't", you actually mean "we shouldn't" or "we mustn't".

Moreover, I'd like to point out that your argument that many more people die if we lift the lockdown is based on the model simulations. These model simulations already don't match the reality: we do not observe predicted exponential decay of cases to 0. When we lift the lockdown, and the outcomes will keep not matching the models, which consistently overpredict number of deaths, I expect people like you to keep saying that if we kept lockdown longer, we could have avoided more deaths, based on... model simulations.

I think we need to stop confusing the map, that is, the model simulations, with the territory, that is, the reality.


Exactly. LA can't even open a beach. The beach is the safest place to be right now.


LA's beaches are starting to open tomorrow [1]. LA is making clear progress towards reopening. I understand they aren't doing it as fast as some want, but that isn't an excuse to pretend that no progress is being made at all.

[1] - https://twitter.com/lacdbh/status/1259933680408997888


Totally. And what about all the non-essential businesses? A friend of mine owns a dog washing business. None of his employees want to work because 1. they earn more on unemployment and 2. he can’t re open anyways because he’s not essential.

So he just sits around day after day watching his business go down the toilet.


...until unemployment insurance runs out. People like that don't understand that it's not forever.

Or worse, they run it out, go back to work, then there's another lock-down because infection rates go up. Now they're not eligible for unemployment at all because they haven't paid into the system for too long.

(At least that's how it works in the three states where I have experience filing for unemployment. I doubt that California lets people collect money forever.)


There's likely to be a teary-eyed politician who goes up in front of Congress as unemployment benefits end and insists they be renewed because it's almost Christmas and how heartless must you be to take food out of an orphans mouth during the holiday season yada yada

There's a long history of this happening in the USA if you're interested: https://www.amazon.com/High-Cost-Good-Intentions-Entitlement...


Once he is allowed to re-open, won't the first issue go away as well? I believe unemployment benefits are contingent on not having a job to go back to. If they're allowed to return to work and your friend wants them back, then they couldn't choose to stay home and continue to collect unemployment.


The other perversity is that grant conversion, i.e., forgiveness of the PPP loan, is contingent on rehiring. If the requisite number of former employees do not return, the business will be required to repay, and that is tantamount to paying employees with no ROI.


Non essential businesses are being reopened gradually based on risk. It's not like everyone is shut down for 3 months, then the next day everyone is open. Newsom just said today that pet grooming is next. However other businesses like concert venues will probably have to wait until phase 4


Pet grooming has been classified as essential (by California) since late April. Our local groomer reopened quickly after that. There might be some cities that have other restrictions, but grooming is already open in most places.


> None of his employees want to work because 1. they earn more on unemployment

He should pay his employees more money.


He raises prices to support higher pay, dog grooming now costs $500, none of his former customers can afford it, the company goes bankrupt and the employees are back on unemployment again.

You can't just pretend that every business can magically afford to raise wages. This isn't Apple paying kids in China 50 cents to build an iPhone they sell for $1,000, this is a local business that's probably barely able to pay the founder a middle-class salary in the best of times.


I think this is a valid point, but one consideration that feels missing from a lot of these kind of disucussions is to what extent the economy will "come back", even if every restriction were lifted.

If people are afraid to be in public, then the restaurants, bars, and shops won't see full-scale business return. Those jobs and business will be lost anyway, perhaps with more people infected than necessary. Or, we try and find some middle-ground "new normal" that lets people feel safe in public. Or something else? I have no idea and I doubt many people in this comment section really know either.


"I think this is a valid point, but one consideration that feels missing from a lot of these kind of disucussions is to what extent the economy will "come back", even if every restriction were lifted."

Because there's no point debating such a question. Arguing that we should leave lockdowns in place because people would be too scared to go outside even if we lifted the lockdowns, is tautological.

If the argument is that people are going to stay home anyway, then we should open the economy on first principles.


I don't think its that simple, because it doesn't have to be all or nothing. I think CA has the right idea to lift restrictions at the state level so that less at-risk rural areas can try it out. It will give an idea as to what LA county would need to do: if things go okay then a reopen is reasonable, if people don't feel comfortable without some kind of "distancing" rules then those would need to be considered, or something else.

So yeah, of course there is a point in debating such a question. And there are real ways to find answers. Probably even better ones than what I said.


Many of the people who are unemployed now will go back to work sometime in the next three months. The article is framing that three month timeline as closer to the end of the reopening process while many of the comments here, including yours, are framing that three month time frame as the start of the reopening effort.


Well, if we take $2k payments and make them monthly, in a decade or so we'll reach a meaningful percentage of the direct costs of the Iraq/Afghan wars.


$2,000 x 150,000,000 = $300,000,000,000

That's 300 billion dollars every month... And that's for only 150 million adults...(there's a lot more than that)

It's estimated to have cost about 3 Trillion dollars for the Iraq war, a 17+ year conflict[1].

At $300 billion a month (on the extreme low end), that's $3 Trillion every 10 months.

Put another way - we could fund another 17+ year long armed conflict every 10 months at that rate.

The entire 2021 federal budget is projected to be around 4.8 Trillion... and they estimate they'll only bring in $3.8 Trillion in revenue.

Disregarding that your projection is grossly innacurate, how is this something we can do?

[1] https://en.m.wikipedia.org/wiki/Financial_cost_of_the_Iraq_W...


I know this is going to ruffle a lot of feathers, but raise the top marginal tax rates. Not a nominal raise, but something significant, like 20%. And the cap gains rate as well.

Basically move to a more redistributive system like Europe, which can afford to do this for a lot of their citizens.

That's how we've funded war-like efforts in the past, and if this is likened to a WWII style mobilization effort (which it has been by several politicians, then the well off citizens need to pitch in much more than they are now).


It would simply not be enough.

If you took all of Bill Gates' ($107 billion) and all of Jeff Bezos' ($145 billion) and all of Larry Ellison's ($59 billion) money... every single penny, you'd still wouldn't be able to pay for even a single complete month of this program.

It's an enormous amount of money.

What the Nordic counties do doesn't scale to the third largest country by population... Not to mention they don't pay for their own military protection (barely) among other differences.

Funded wars? Wars have almost always involved massive debt being taken on by the federal government. It's just simply not feasible to run that way for long term.


> What the Nordic counties do doesn't scale to the third largest country by population

Why does the absolute population number matter in this case? Whether you have 1 million people or 300 million, the viability of any tax scheme hinges on the relative proportions.

In any case, what Nordics actually do is tax everybody's salaries. Not just the rich, but also the middle class.


> Why does the absolute population number matter in this case?

Because GDP and total potential tax revenue isn't proportional like you assume.

In Norway's case (5 million pop, $434 Billion GDP), that's $86,800 per person.

In the US' case (328 million pop, $20.5 Trillion GDP), that's $62,500 per person.

A small country with a couple very successful businesses can spread that total potential tax revenue further. Particularly if they don't pay much for their defense costs, but I digress.

In the US, we have a lot more people, and most of those aren't high earners and don't contribute much to the GDP nor tax revenue. It's estimated about 76 million Americans pay zero federal taxes[1].

The point was, at our scale, we'd be doubling our national budget to accomplish this any way you look at it.

That's going to require a lot more than just taxing the rich more. It's going to require a lot more than just taxing everyone more.

The scale of this is difficult to think about. People often point to the bloated military budget as something to pull from. Well, the projected 2021 budget for the entire DoD is $740 Billion. At the rate of spending we're discussing, that's just about only 2 months of this program... to the cost of having zero military.

All that for what purpose? Just to give some of it back every month? That would basically just be a "feel-good" program then... confiscate your money and give it right back to you in a government stipend.

I just don't see a realistic way to pull this sort of program off. Unless we take it down to something more reasonable like $100 a month... which would only be $15 Billion per month, $180 Billion per year. That's much more manageable... but what's $100 going to do realistically?

[1] https://www.businessinsider.com/personal-finance/how-much-do...


I did some number crunching on UBI a while ago. It's totally doable by taxing everybody more with heavily progressive taxes.


Sorry if I don't just take your word for it.

As I've laid out... you gotta come up with $3+ Trillion more every year... at a bare minimum. The real numbers probably look closer to $4-5 Trillion if the plan is to give everyone over 18 this $2,000 monthly, plus you have all this Bureaucracy you'll need to manage this program. You gotta double the national budget and then some.

There are no numbers that make sense to pull that off. It's a fantasy to think otherwise.


You forget that with real UBI funded by progressive taxation, people past a certain point pay more into the system that they get from it. So in practice, not everybody actually gets $2000 more every month relative to their current income. I would suggest taking IRS numbers for various income tax brackets, putting them into Excel, and playing with the numbers to see just how progressive you need to make the tax to make sure that nobody gets less than minimum wage, for starters. I'd share my spreadsheet if I still have that around.

The bureaucracy to manage such a program is orders of magnitude less than for any other welfare program, because it's not means-tested. In fact, since IRS already has the bureaucracy and the logistics to handle tax returns, there's no reason why this couldn't be tacked onto that.


The same way we’ve funded endless wars for 20 years?


Income tax.


People feed their families and provide them with healthcare by working as waiters, bartenders, and stylists.

There are a lot of them. Stop acting like this is just about entitled tech workers demanding a night on the town.


Almost everyone I know in the service industry is the same or better money now compared to when they actually worked (notable exception being people that got paid under the table or lied about tips)


[flagged]


What are you talking about? It's just a sideeffect of how unemployment + stimulus money was doled out (and how they're treated for tax purposes)


This is NYC a week ago. It goes around the block.

https://ibb.co/tQdf3RS

It's a food line. This is what they got at the end

https://ibb.co/KKnC0pd

Politicians simply don't get it. White collars do not get it. They will, soon. Not politicians, the white collars.


Usually the misleadiness goes no deeper than the headline, but in this case the article is also contributing, and maybe not only the article but the statements the article is reporting on. "Stay-at-home orders will with all certainty be extended for the next three months" is a strange way to describe the process of opening up. Most likely this way of putting it is the product of some political constraint-solving.

I've replaced the title with a phrase from the article that manages to be both accurate and noncommittal.


For what it's worth, none of that subtlety is reflected in the article's 10+ word title, at all.


> For what it's worth, none of that subtlety is reflected in the article's 10+ word title, at all.

You don't go to a headline for subtlety.


One thing I wonder is how well limiting certain things people can do will work. For example, if only the beach or parks are open, will you actually have a higher concentration of people showing up there that normally wouldn't because it's one of only several choices for things to do? Even if retail is limited to like 50% capacity, will you just have the people waiting to go in the store pile up into a crowd outside waiting to go in? I doubt the stores will be able or want to enforce distancing outside their location. It is going to be interesting to see how this plays out.


Seems like a great argument for good branding. "Partially Closed" vs "Partially Open".


There is no way that people will keep complying for such a long time. I am all for mask wearing and work from home as much as possible but a lockdown for such a long time is crazy. What’s the goal? Flattening the curve or no deaths at all? We will probably see in a few months where things are going but from the stats I have seen so far the connection between lockdowns and lower death rates is not that strong. By now I would have thought that all hell would break loose in Florida but it doesn’t seem to be happening.


>By now I would have thought that all hell would break loose in Florida but it doesn’t seem to be happening.

How long ago did Florida open everything back up? If I remember correctly it was just May 4th?

That's only 8 days. This thing lags by two weeks. Put a note on your calendar to check again in 7 days.


GA "opened up" salons on 4/24 and restaurants on 4/27. I say that with quotes since many places remain closed for dine-in service. Nonetheless, it's been 2 weeks and we've only seen a slight decrease in case rates: https://www.nytimes.com/interactive/2020/us/georgia-coronavi...

Meanwhile, our testing rates have shot up to the ~7500/day range and our positive test rate has gone from ~25% down to 13.2% today: https://docs.google.com/spreadsheets/d/1wrGsD3T_JIvKwsudQwVH...


An important caveat here is that Georgia has also seen only a slight increase in non-lockdown activity despite whatever Governor Kemp may say Georgians should be doing: https://www.lawyersgunsmoneyblog.com/2020/05/number-of-peopl...

The lockdown and resulting economic damage is much less an effort of state enforcement than it is individuals being (correctly) terrified to engage in commerce unless absolutely necessary.


There's been a huge increase in activity in Atlanta since the reopening. Not pre-lockdown levels of course, but lots of people outside the past 2 weekends, on the beltline, etc.


This is what I see in my network; people continue to self isolate. The effect would be lower case/death peak at the expense of economic “back to normal” that seems to be priced into the stock market.


"The lockdown and resulting economic damage is much less an effort of state enforcement than it is individuals being (correctly) terrified to engage in commerce unless absolutely necessary."

What makes you so sure that average people should be CORRECTLY terrified of this virus?

If I'm in a high-risk category, I get it. But what about others? Are the rates of severe infection remotely high in people who aren't elderly, immuno-compromised, or with underlying conditions?

Keep in mind, the advice on this SHOULD be different depending on where you are. NYC? Sure, be incredibly vigilant. Nebraska? Probably not a big deal.


Considering that Nebraska is turning into a hotspot, you might want to reconsider your last statement.


Source for Nebraska turning into a hotspot?

Looking at all the trackers I have bookmarked I'm not seeing much of an indication of this. Yes, confirmed cases seem to be up in the last week, but that seems to track with increased testing (a good thing). The rate of positives is showing a decline over the same time period.

More indicative of an outbreak would be increased hospitalizations or deaths. Hospital bed usage has been at the same level since mid April, and deaths have been at a steady 1 to 3 per day since the end of April.

Sources:

https://coronavirus.1point3acres.com/en/test?state=NE

https://covid19.healthdata.org/united-states-of-america/nebr...

https://infection2020.com/#


https://covid19-projections.com/us-ne

and

https://www.nytimes.com/interactive/2020/us/nebraska-coronav...

are the two I count on the most. I don't really trust any of the confirmed case counts to matter much since testing isn't consistent. In most parts of the state you can't get tested unless you're exhibiting symptoms.

One of the local hospitals reported that they're currently at 50% ICU capacity just with COVID-19 patients.


Nebraska's not a hot spot. Another poster put data and references down supporting this.

The reason you have a few hot spots WITHIN Nebraska is due to 4 different meat processing plants in 4 different counties. The worst hit county, Dakota County, is home to a massive Tyson facility.


And explain to me why this doesn't make Nebraska a hotspot?

Do those workers magically teleport elsewhere after work? Do they not go to the grocery? Do some of them go to church? Do they not wind up in the local hospital?

You don't just ignore inconvenient data.


I think it's a simple fact that these are localized infections. The reason meat processing facilities have been hot spots has to do with close quarters combined with cold temperatures. When the employees leave those buildings they're not interacting with the general public in refrigerated facilities.

The point I'm making is that if this was a dispersed infection that was spreading through normal community interactions it would be much worse and harder to contain than if it's at a few facilities..

It's almost like depending on where you are and what the data says you should have a different action to optimize the outcome... And that's the point. This one size fits all everybody act like we live in Wuhan isn't working well.


>What makes you so sure that average people should be CORRECTLY terrified of this virus?

50% of Asymptomatic and 80% of Symptomatic cases on the Diamond Princess had ground glass opacity on CT scans. Usually indicates irreversible lung damage. Care to gamble on decreased lung capacity for the rest of your life?

https://pubs.rsna.org/doi/10.1148/ryct.2020200110


At least for Illinois, models predicted that a May 1 reopening would lead to a very large second peak in June with high probability. See e.g. https://www.chicagobusiness.com/greg-hinz-politics/look-insi.... It's more than 2-week lag time due to the time required for R_0 to increase (due to people's habits), a number of generations required to noticed, and the general lag time of the issues.


This perfectly illustrates the "opening up" paradox. If you, as a Government, aggressively open but the public still sees risk, not much will change. People won't go outside much because they perceive risk. We'll have to wait much longer to actually know whether opening aggressively is a mistake or not. From my perspective the risk of opening too early and starting a second wave much later in the year, is worth taking very seriously.

I'd say anyone drawing conclusions from a a few weeks data has a 50% chance of getting burned at this point.


That's interesting because I live in a country where it's the opposite, e.g still only essential services after 2 months, limited goods sold, ban on cigarette and alcohol sales, curfews for shopping.

Point is I think the opposite of what you're saying might happen here, i.e. regulations loosen and there's going to be a disproportionate number of exposures as a place not so tightly regulated


I could have been more clear. My point is that aggressively reopening might still be dangerous, but it'll take a while for the public to convince themselves it's safe enough to start going out, even though it isn't. I'd imagine this would be driven by both consumers not wanting to get sick _and_ businesses trying to avoid liability for employees and customers.


This graph shows that things will be slow even when 'reopened' due to human behavior, which means you may not see Covid spikes for a while yet.

https://compote.slate.com/images/6e5b79c5-c6db-47ab-95cd-7c9...


This seems like an argument for letting states “reopen” then...


I've heard that Georgia also just changed how they report cases - instead of date of diagnosis, it's date of onset - so the numbers themselves now have additional lag and we won't know a given day's real numbers until a week or two later as they're backfilled.


I think that is intentionally being manipulated. They are pushing for asymptomatic people to be tested in droves. The % is accurate but the biases in sampling don't make it an apples-to-apples comparison anymore.


I've been watching closely, one convenient thing about this is we only have to wait about 3 more weeks to have the definitive answer on GA, FL, and maybe even TX. It's not like we have to wait decades to see it play out.

Go here and scroll down to Cases by US States/Territories per Day and highlight GA, FL, and TX then play with the metrics. All three seem pretty stable so far. http://91-divoc.com/pages/covid-visualization/


7500 tests per day is a drop in the bucket. There are ~4M people in Georgia. It would take 18 months to test the entire state at that rate.


The reference is to all the spring break parties taking place two months ago https://www.local10.com/news/local/2020/03/14/south-florida-...

Arguably, most of the party-goers were out-of-state, but it also would've been relatively easy for authorities to link a spike in deaths to those events. So far we have not seen the spike take place.


> it also would've been relatively easy for authorities to link a spike in deaths to those events. So far we have not seen the spike take place

What makes you say it "would've been relatively easy" given contact tracing is not widespread in the US and certainly wasn't during the weeks of US Spring Break (ca. mid-Mar)?

In any case, you are mistaken that "we have not seen the spike take place". [0] See, especially, the map "generated by Tectonix GEO and X-Mode Social" about 1/3 of the way down the page.

[0] https://www.nytimes.com/2020/04/11/us/florida-spring-break-c...


> What makes you say it "would've been relatively easy" given contact tracing is not widespread in the US

Plane tickets were bought, credit card spending took place, cell phone towers were pinged, hotel reservations had names linked to them, relatives, friends or colleagues aware of the whereabouts and can be interviewed post-mortem?

For what it's worth, they're able to pinpoint specific parties or night club performances https://www.pasadenastarnews.com/2020/05/09/pasadena-identif... https://ktla.com/news/local-news/former-rancho-palos-verdes-...


People on spring break are mostly young and the people they interact with while on spring break are mostly young. You would probably need to look at contacts two or three degrees away from them to notice the spike. Has there been an in depth analysis of the extended network of those people?


But even that has a policy implication that stay-at-home order can exempt people of certain age.


If a young person goes to a nursing home and infects everyone, is it not connected to spring break unless the old people went to spring break?

Keep in mind that the young person might be a medical worker, or in the family of a medical worker.


IANAL, but I imagine a stay-at-home order that is based on age would result in constitutional challenges.


It's unlikely the current orders would survive any court scrutiny.


Where are the emergency injunctions, then?


Alameda backed off elon musk pretty fast, probably because they had little legal footing

https://www.forbes.com/sites/rachelsandler/2020/05/13/elon-m...


We had a big spike in Quebec after spring break as people returned from Florida and France. The province is still the worst in Canada. BC took note and advised people not to travel for spring break (our break here is later). BC is doing very well by comparison.


I'd be a lot more worried about the people returning from France than Florida, they've had a pretty major outbreak.


On 3/14 we had about 3k COVID-19 cases in the US. By the end of April, we had about 200k. Our contact tracing efforts at the time (and now) likely aren't sufficient to tie specific cases back to Florida's spring break, but it's unlikely to have helped.


We had 3k reported cases, not 3k cases. That's a large difference. I wouldn't be surprised if the actual number of cases from 3/14 was hundreds of thousands.

There were 58 deaths reported by 3/14. If you assume that mortality is 1% (probably on the high side, but good enough for estimates), that translates to ~6k cases.

However, since we know that deaths lag cases by 1-3 weeks (let's assume 2 weeks for the analysis), we should be looking at deaths two weeks from 3/14, which would be 3/28.

By 3/28, there were ~3k deaths from COVID-19, meaning that the true estimate of the number of cases from 3/14 is likely around 270,000 cases (estimate range is 130K - 800K).

This also means that there were about 8.5 million cases in the US on May 1st (I happen to think mortality is closer to 0.5%, so that would be ~17 million cases instead), and that we've most likely crossed the 10 (or 20) million case mark by now.


> Arguably, most of the party-goers were out-of-state, but it also would've been relatively easy for authorities to link a spike in deaths to those events. So far we have not seen the spike take place.

How would we know? They are spread across the nation.


> That's only 8 days. This thing lags by two weeks.

Two weeks is the period within > 99% cases exhibit symptoms. The median incubation is between 4 and 6 days.


But the spreading continues, and I can see it taking multiple generations to make a clear trend. It's not like in 2 weeks there are 10x more people, the R0 is not that high. You have to have enough to be noticeable compared to the previous visible amount.


8 days?

Hello from Peru! Where I have been in lockdown for 58 days straight and counting...


The person you replied to is talking about NOT being on lockdown for the past 8 days.


The eight days is in reference to Florida easing some lockdown restrictions. Most of the US has been under some sort of lockdown since mid to late March.


With the military outside making sure you stay in or else you get arrested? Not sure my concept of lockdown is the same as yours.


100% not that. It's more of a suggestion to stay at home. Restaurants and bars are closed to dine-in. Movie theaters and other fun things are closed.

We 100% do not have military threatening arrest for going out. At this point, many (rural) police districts and politicians are even saying they won't enforce the stay-home orders anymore.

So. Yeah. Not quite the same.


How are things in Peru, COVID-19 wise?? That's my wife's home country and she's not heard a lot about how well (or not) things are going.


Growth is slowing down. ICUs are still not completely full but getting there. Certain areas in the Andes do not have any cases which is great, but the infection rates in certain cities (like Iquitos) are high, mainly because of markets.

Summary: under control, but still not great.


Why did things get so bad in Ecuador? Is the border still tightly guarded?


Ecuador: Health system collapsing (reaching the max point of ICUs) causes the mortality rate to spike.

Perú: there are 992 for the entire country (195 are still free).


I'm in my 9th week here.


> How long ago did Florida open everything back up? If I remember correctly it was just May 4th?

Parent is referring to weeks and weeks of predictions that Florida would be utterly decimated because of large Spring Break parties, taking a long time to shut down in the first place, beaches not closing down for a long time, etc.

Florida, like apparently everywhere else in the US, has been perpetually “two weeks away” for the past six weeks from becoming New York City.


==Florida, like apparently everywhere else in the US, has been perpetually “two weeks away” for the past six weeks from becoming New York City.==

Almost the exact time most states started stay-at-home orders.


The goal is drastically cut down both deaths and hospitalizations. There are various estimates for how to get to herd immunity, 50% of population has to have it, up to 75%. The current estimates for how many people die ranges from 0.3% (3/1000) to 0.5%. A lot more end up in the hospital, perhaps 5-10x more than those who die, I don't have as good a number for this. [1] has good info.

330 million * 50% * 0.005 = 825k die. 5-10x in the hospital is 4 million to 8 million. Those are big impacts.

Some people want to argue the next thing "those are mostly old people or sick people", so too bad for them?

1. IHME, https://covid19.healthdata.org/united-states-of-america


Since there are no wide scale antibody testing in most of the US due to lack of coordination/faulty health system perhaps we can look at closed systems to ascertain the true death rate. Looking at Lompac prison it appears that 70% of the inmates have tested positive for covid-19 [1]. If the remainder of the inmates are tested, a somewhat accurate death rate can be found. I feel like the only people that should quarantine should be pre-existing medical conditions and the very old, but want to see hard data to back this up, interesting info from the linked article, "The vast majority of positive individuals report minor or no symptoms" I don't know how soon from positive test to infection these cases are as well as the age distribution at the prison but this should be looked at regardless.

[1] https://beta.trimread.com/articles/14804


> Some people want to argue the next thing "those are mostly old people or sick people", so too bad for them?

The argument re: old/sick people is a combination of "these people have fewer years left to live anyways, making deaths less impactful" and "this is a smaller subset of the population that can be isolated while the rest are set free".


It's probably not the best use of time to cite data referencing 300 million people spread across almost 4 million square miles. Each state, and really each county, is its own unique circumstance/set of data.


It's not only a question about how many have to get it to reach herd immunity but also how long this will take. 3 months in lockdown won't cut it and there is no vaccine available in 3 months.

> Some people want to argue the next thing "those are mostly old people or sick people", so too bad for them?

No, they are most vulnerable and should therefor treated differently than other groups that are not. They also don't tend to work. Considering that ~20%-50% of covid deaths are nursing home residents, protecting them should be priority, not shutting it all down in hope it will dry up over the next 3 months, it won't.


IHME’s projections have been extremely inaccurate so you can’t take that one and throw it out


Downvoted for the truth? What is this Reddit? Go look at all of IHME’s predictions and the actual numbers. Way off.


How are you so sure people will stop complying? Is the risk of opening everything up just to shut it down again really worth it?

I think people are smarter and more accepting of the status quo than those who are making the most noise. As for those who are overburdened by the lockdown (i.e. lost jobs), its on the governments to provide the safety net until we have everything under control.


> How are you so sure people will stop complying? Is the risk of opening everything up just to shut it down again really worth it?

I live in California and I can tell you that people are already extremely over this shit. Go out and about and hardly anyone is wearing masks, hardly anyone is social distancing. Some people are trying ... but you are only as strong as your weakest link. It's tough to keep up stringent personal standards when everyone around you has said fuck it and given up.

So I completely 110% agree with the parent commenter that people have already been demonstrating they don't want to comply. I mean, it's human nature. No one wants to be told what to do.

The hospital boat off the shore is completely empty (it treated a total of 77 patients). Most of our hospitals are significantly below capacity. We've all been sitting around twiddling our thumbs waiting for the apocalypse and nothing is happening. Just crickets. Unavailable unemployment funds, closed businesses, lost jobs.

The one thing everyone is learning from this is that the government will not help you. It doesn't matter how liberal or conservative your state is, or whether you believe most in federal or state governments ... everyone is doing a shitty job in one way or another.

So if the government is not going to do fuck-all for me, why should I do fuck-all for the government?


> The hospital boat off the shore is completely empty. Most of our hospitals are significantly below capacity.

I think a lot of people don't realize this. My wife's friend is a nurse shift supervisor at our local hospital. The hospital is practically empty because there are no elective surgeries. They've been laying off nurses over the past month. She had her hours reduced. She's expecting to be laid off soon too.

If the whole point of this is to buy time for hospitals, doing so to the point where they have to start laying off staff members is a pretty dumb way to do it.


And so many elective surgeries are out-patient meaning there was no reason to pre-emptively suspend. If the capacity overwhelm that never happened had actually happened, we could have suspend surgeries then. And frankly it should be on a case-by-case basis. Some surgeries are more important than an extra hospital bed-day.

I have a large labral tear in my shoulder, an impaction fracture on my humerus, there’s a bone bruise with bone marrow leaking out, my glenohumeral ligament is stripped from the glenoid rim, I have a new area of full-thickness articular cartilage loss...

...And because CA suspended ALL elective surgeries statewide for a month, my surgeon has a month backlog before he can get to me. Until then I cannot perform any of the activities that keep me healthy and sane. Also my arm is at risk of dislocating in my sleep until I get surgery

Suspending elective surgeries was the dumbest possible decision we could have made yet our leaders won’t ever admit that they fucked up and completely botched their covid response.


I hear what you're saying, but my understanding is that PPE shortages were behind the decision to suspend other medical activities.

Failure to maintain an adequate stockpile of PPE is probably what made the lockdowns necessary, more than anything else. If everyone in the US could have been given masks and instructed to keep their distance from other people, that would probably have been enough to allow us to lock down only the most vulnerable. At least we could have begun with that approach, and moved on to heavier measures only if/when they proved necessary.


Some of that was/is pure speculation, they had data to say X number of people would need to be hospitalized, so they need Y number of PPE

Y was more than they had to they panicked

When X was found to be a massive over estimation they still doubled down and said "well in 2 week we will be over run"

2 weeks came, and it was "well in 2 weeks we will be over run"

2 weeks later and "well in 2 weeks...."


Government has to subsidise them to be ready in the event there is a surge in cases. If people are being laid off there was no point to cancelling elective surgeries.


There was a real PPE shortage.

There was also very poor visibility on the likely case growth, because testing was so limited. It's only the last couple of weeks where there are enough tests to be testing people with likely exposure instead of just people that were gravely sick (so now healthcare workers and first responders and other essential workers can be tested without requiring that they be symptomatic).


Aside from being "over it", I think it's also that people are (correctly) perceiving their individual risk to be very low and acting accordingly.

It's a bit of a birthday paradox problem in that if you have large groups of people not social distancing in an area with pretty low prevalence like CA, the risk to any one person of contracting the virus could be extremely low, while the risk that some of those people will contract is extremely high.

Americans are, for better or worse, really not used to thinking in collectivist terms.


I like the birthday paradox analogy. Nassim Taleb, Black Swan author, has a paper on the same idea. https://www.academia.edu/42223846/Ethics_of_Precaution_Indiv....


Herd immunity will require between 60-80% of the population to be infected. At the bottom end of that scale it's 198M people. The IFR is roughly between .1% and 1%. The range for these deaths will be 198K to 1.98M. Fatalities. Hospitalization is roughly 5%, so between 1M and 10M hospitalizations with unknown long term effects.

Think of it this way; if 2/3rds need to become infected before this crap is over, don't you want to be in the 1/3 that doesn't risk death/hospitalization?


Still, no. You're operating off of knowingly bad data and ignoring serological surveys (which are also pretty bad data at the moment).


Unsure why you are getting downvoted, I am seeing the same thing in the bay area, but this is hospitals being ghost towns, etc. I do see alot of people wearing masks but doing it wrong, people wearing them in their car by themselves, or out all alone and wearing them. My own Doctor has told me covid-19 cases have fallen off a cliff and the tents in hospital parking lots are being torn down unused.


If I'm out doing two errands - e.g. I went to Home Depot for a light bulb and air filters and then to a grocery store - I will keep my mask on in the car. Unless I've brought a change of gloves - I will not touch my facemask until I've returned home - discarded my gloves and then removed my mask.

So - you may have seen someone like me (who doesn't want to touch his face or mask) driving with a mask.


Put some hand sanitizer in your car. Problem solved.


I can't speak for the original commenter, but I guess I just don't see it as a big problem. I have hand sanitizer in my car, but I dunno, a mask isn't so uncomfortable that I feel like I have to fiddle with it a bunch depending on whether people are nearby that second.


> I live in California and I can tell you that people are already extremely over this shit. Go out and about and hardly anyone is wearing masks, hardly anyone is social distancing.

It's a big state. Compliance varies a lot by area, and by local culture. Just because there are some people who don't take social distancing precautions doesn't mean that those who have the civic sense to take those precautions should abandon their efforts.


I'm just painting a picture of the vibe I am experiencing as a native Californian who has been out a lot in LA and OC. I still wear a mask when I am out and do my best to abide by social distancing rules. We have lots of hand sanitizer in our vehicles, about a hundred medical-grade masks, and a lot of bandanas and other stuff in case we need it.


Perhaps this explains why SoCal is doing poorly compared to the Bay Area: https://www.latimes.com/projects/california-coronavirus-case...


No, people are pretty over it in the Bay Area too. I don't know a single person who's staying within the letter of the stay-at-home orders any longer. (Admittedly, everyone I know has been pretty diligent about masks and handwashing since March.)


No, MY anecdotes tell a different story altogether!


If you know of any polls about compliance with stay-at-home orders, I'm all ears. I get the impression that pollsters are deliberately avoiding asking about it.


I’m in the Bay Area too, and most everyone I know has been complying, more or less.


If you look at our counties by population, LA and OC are doing pretty stellar relatively speaking. Add up all the counties in "SoCal" and you're looking at roughly 20 million people. The Bay area is what... ~4 million for SF/Alameda/Santa Clara? Not trying to start a pissing contest here but the fact that we're going to have more cases and deaths is just a numbers game.


> Add up all the counties in "SoCal" and you're looking at roughly 20 million people. The Bay area is what... ~4 million for SF/Alameda/Santa Clara? > the fact that we're going to have more cases and deaths is just a numbers game.

The rates are higher in LA/OC too, not just the absolute numbers.

The LA metro area population (which includes OC) has 13 million people. There are 36k confirmed infections. So the confirmed infection rate is .28%. There are 1600 deaths so far, so the death rate is .01%.

The Bay Area population is 7.75 million, the # of infections stands at 10k, which is confirmed infection rate of .13%, and deaths are 360, which is a death rate of .005%.

It's absolutely not a contest, but the rates are what they are. If you choose to expand either areas' stats out to include their neighboring counties, the differences in the rates don't change much, but will eventually converge with CA wide rates, since this disease is most prevalent in urban areas.

Both the Bay Area and LA/OC appear to have lower infection rates than many other urban parts of the country and world, but the Bay Area is currently seeing both a lower infection and death rate than Southern California. Only time will tell if that holds.

Stats from:

https://en.wikipedia.org/wiki/Los_Angeles_metropolitan_area

https://en.wikipedia.org/wiki/San_Francisco_Bay_Area

https://coronavirus.jhu.edu/map.html


Yeah, but most of the charts and graphs further down are per 100k, and the doubling rate for SoCal has tended to be much worse whenever I've checked the page. (I only bring it up because I've wondered on more than one occasion what might account for the difference.)

Fortunately, it seems to be leveling off somewhat, except for Santa Barbara. I really, really hope we can keep it that way.


In Santa Barbara, the stats are bad because they have been counting infections at a federal prison in Lompoc, where there are something like 70% infection rate and 2 deaths already.


It might look like people are over it, because all you see outside are: the people outside. For every dummy out there horsing around during a global pandemic, there are 100, maybe 1000 following the rules and staying inside. When you sprint out there to grab some groceries, you see people out and about and assume "people are over it." But all you are really seeing is the few people doing essential business and the few "I just wanna break the rules" people.

I also noticed that traffic hasn't really changed in my neighborhood and people all seem to be ignoring stay-at-home, but have gradually come to the conclusion that that doesn't have anything to do with the actual stay-at-home compliance rate.


I guess it depends on where you are (California is a big state!), but at least here in SF people are still taking this very seriously. Almost everyone on the street is wearing a mask.


While there is a requirement to social distance, at least in the Bay Area there is no requirement to wear masks while walking outdoors.


Honestly, they should just open up, pass some mask rules and other targeted measures, and then stay open come what may. A broad, untargeted shutdown was always both the bluntest and most expensive approach to this problem. Perhaps its sole merit is that it was really, really good at getting peoples' attention.

Unfortunately, LA is governed by people who do not understand what "the economy" actually means, and view it as a thing to disdain. They will not bear the costs of lost jobs, lost medical screenings, lost K-12 education, and lost social services (both now and pursuant to the city budget shortfalls).

> its on the governments to provide the safety net until we have everything under control.

There is no plan for "under control." We are still looking at a scenario where 50-70% of the population gets the virus. There is a possibility of a vaccine, yes — but no one credible suggests we ought to be planning for it in the next year.

Plan for a 2-year shutdown order, or plan to reopen soon. A three month shutdown, in the middle of that range, doesn't make any sense at all.


I happen to entirely agree with you, but the counterargument is that a treatment (not vaccine) becomes available earlier which makes the incidence of actual lasting damage from wuflu so low as to not warrant any more shutdown.


The plan was to get it under control with testing, not a vaccine.


>> its on the governments to provide the safety net

That's not really working out now. Plenty of people in WA state as well as NY state are waiting on unemployment claims dating back to March. Fed is backstopping large corp. losses while the every day person gets nothing. WA state is rolling out a "science and data" dashboard that looks like an MS Word clipart project from an 8 year old kid.

Our governments are mostly inept at anything resembling complexity. Something ten times more complicated and difficult like this shows how slow they are to action.

This was foreseeable. The WA state subduction zone report shows that in a simulated catastrophe due to liquifaction / earthquake in the Pacific Northwest, mean time for government intervention for aid-related activities was on the order of 3-4 weeks.

We talk about how large corporations privatize gains and socialize losses; government agencies are quick to act on authoritarian measures like lockdowns but slow to act on remedies to keep them going in an equitable fashion. The only surprising thing ongoing in the nation right now is the degree of ineptitude of our government agencies. Not even I thought they were this bad at getting aid to people.


>its on the governments to provide the safety net until we have everything under control.

Let's be clear-- there is no true safety net for middle-income professionals. We can draw down savings and cross our fingers that this resume gap doesn't kill a professional career. And that's just the financial and career consequences. There definitely are other consequences of unemployment too.

I feel fortunate not to live in L.A. county but the public health response my state is not a lot less draconian. I just am astounded. I would love to wrap everyone and everything in bubble wrap as much as the next person to protect everyone from a very dangerous world but this is too much.


Careers never fully recover from extended unemployment. There is plenty of research on this from previous downturns.


There hasn't been a "previous downturn" with this concentrated (size × time) an unemployment spike. It's weird to claim we know now how employers will react to it yet when they see "unemployed, May 2020" on a resume.


Didn't recessions in the US, 100 years ago, used to be huge and always have V-shaped recoveries?


The Department of Labor didn't collect unemployment numbers until the 1940s, but it's my understanding that the recent spike in filings is unique in size since they did.


Resume wise, you’re in the same boat as everyone else


Everyone's situation is different. Unemployment isn't 100% and the class of 2021 won't have this gap. Think employers are rational enough to iron that out? Nah, you have more faith than me.


No, I live in a different city and I am fortunate to still have a job. A different boat exists, and I am in it.


“its on the governments to provide the safety net until we have everything under control.“

There are limits to this and the burden is distributed very unevenly. If you have a spa, your business is taking a big hit , but the landlord is not required to stop asking for rent. We would have to switch the whole economy to a non profit model, otherwise the lucky ones make out like bandits and others are being driven out of business.


This "some businesses are saved" effect that's happening now is the most unfair thing, in my opinion.

If the government wanted to provide support to keep everyone roughly where they were before the pandemic, that's great. But picking and choosing is really unfair.

And it seems to be hurting small business owners and the middle class the most. Unemployment payments max out at what, $4000 per month? Meanwhile a middle class professional in the Bay Area might pay that much just for rent, before considering food or other expenses.


Freezing rents and interest throughout the entire economy would substantially reduce the amount of government assistance needed. It's also not the same as a non-profit economy.


Where is the government going to get this money? Most social programs are funded by income taxes, if no one is working there are no income taxes to take from people to pay the people not working

Unless you just want infinite money printing. The Federal Unemployment increase ends in July, and it highly unlikely this will be extended, so the county of LA has no ability to print more money, or really extend their debt

LA and CA has a real chance of going bankrupt,


CA only has $17.5 billion in reserve as of February. This will most definitively don't last until July. And the government has made it clear they won't bail out states. Once the money drys up CA can't afford to keep counties locked down indefinitely.


It is literally impossible for a sovereign entity like California to go bankrupt. If the state government becomes insolvent then they'll just stop paying some debts and issue IOUs (like with the 2009 budget crisis).


While it has never happened, States unlike the federal government can become insolvent, Issuing IOU's (aka debt) only works if the businesses are willing to accept and loan the state the money. and IOU for services is no differant functionally than a loan, and if your business does not believe the state is good for it then you will stop providing services

Further I am sure employee will stick around for a long time when their paychecks are replaced with "IOU's"

So sure technically there is no bankrupcy court for the entire state, the fact remains that a State can absolutely enter in to a condition that is more or less the same thing as bankrupcy. The feds can just print more money, and most likely CA would beg the feds to do just that to bail them out should that happen

Local municipalities and counties can absolutely go bankrupt. Which is more likely in this situation


Ever hear of the term speakeasy? The high school kids are going to be kicked out of their basement bars by their parents who will want it for themselves.


WA reopened outdoor spaces for the first time this week (to be fair, that also coincided with hot weather). The situation at the trailheads was insane. There were cars lined up along the road half a mile from the parking lot in places (someone posted a video on FB suggesting people don't go). We went climbing and the giant pullout by a climbing/hiking area that isn't even an official trailhead and has no facilities had at least twice as many cars as I've ever seen there, maybe more. Most were hikers and there definitely was no social distancing happening (the climbing areas were busy but there were few enough people to technically be 6ft apart, as is usually the case in this area). Oh, and 2 out of my ~10 teammates at a major tech company took Friday off, one for a "long weekend" roadtrip, one for unspecified reasons... I also doubt that's a coincidence.

I can't wait to see what happens when restaurants reopen. I'm definitely heading to a bar asap.


I dunno. People in West LA already seem to be complying poorly.

There are a lot of entitled people around here, and a lot of folks doing plague cosplay (wearing a mask around their neck like a talisman, gathering but moving to "safe" distance when other people draw close, etc.)


"I think people are smarter and more accepting of the status quo than those who are making the most noise. As for those who are overburdened by the lockdown (i.e. lost jobs), its on the governments to provide the safety net until we have everything under control."

This is the problem with a website for desk jockeys commenting on orders that don't impact their livelihoods.

For any individual, there is a cost/benefit analysis for the lock downs.

The cost is a hell of a lot lower for you and me than it is for restaurant, construction, factory, etc workers who have lost their livelihoods. Let's not forget about the small business owners and independent contractors.

These folks are incurring a much higher cost, and as far as the government assisting them, how smooth do you think that is going?

Have you personally gone and applied for unemployment benefits, or an SBA loan to keep your business afloat?

The government safety net isn't ideal, or pleasant, to deal with. Mayor Garcetti hasn't done well with reforming the LA government, nor dozens of predecessors. The state government of California isn't fun to deal with either.

You probably don't have kids either, if you fit the typical demographic on HN.

A complete failure of empathy on the part of members of the professional/managerial class, who bear little costs of the lockdown towards those who pay the most.

This stay at home order doesn't seem to be informed by updated models and data on this illness. The disease is highly contagious, and deadly at an unacceptably high rate to certain high-risk categories of the population. Those people should change their behavior.

The "wait 2 weeks" thing is what I keep hearing people who are stuck in the "only lockdowns will work" mindset say about every place that has lifted or not implemented lockdowns. It's almost as if they are hoping for it.

Let's be clear: If Georgia and Texas are fine a week from now, that will be good news for the whole country. Even if this good news proves your previously held opinion wrong, it will still be good news. I sense that people on here are hoping for bad news instead, because then they would be right.

Your statement about people being "smarter". Let's be real here, what you mean by "smart" is people who share your beliefs about the best solution to this virus. As if anyone knows with certainty what the best path is. Nobody does. We are all trying our best with the latest data. Except for politicians, who are hell bent on proving that their initial, poorly informed decisions are indeed the way to go by doubling down on them.


I have found getting accurate data to be very difficult.

I saw one chart which allegedly mapped the effect of the lockdown over four weeks with various various indexes:

COVID - significant drop. Death from other medical items - even more significant drop. Death from traffic accidents - even moreso.

Number of deaths from suicide - significant jump. From drug overdose - even more significant jump. Number of mental breakdowns and newly diagnosed illnesses - jump. Number of deaths from people not getting care they needed - jump.

I cannot find that chart anymore, and when I tried to verify the items, I could not.

Anyone who knows the chart I am referring to, or generally reliably sources for these things (and not just COVID deaths), please reply!


If we keep everyone locked up all the time all kinds of deaths will drop!


But if the deaths from suicide, drug overdose, delayed medical care, ulcers and other stress related sicknesses, and abuse are enough, they will offset those numbers.

If the drop into poverty as people lose jobs create slums, gangs, and muggings, there will be a lot more deaths, and those will also offset the numbers.

So, even quality of life aside, I am not sure we come out ahead even on saving lives.

I would like data though, since anyone can speculate. Can someone point to real data?


It's a common speculation, but employment (and recreation, regular life, going outdoors) actually kills a lot of people.

Every % rise of unemployment in Europe during the financial crisis resulted in a 3.5% drop in all cause mortality, and that includes a ~35% increase in suicides. We can probably extrapolate that for a scenario where business as usual also kills a good amount more people due to a pandemic.

Clearly the US, being the US, could be different due to cultural differences in how the poor and underemployed are treated.

https://www.sciencedirect.com/science/article/pii/S009174351...


>But if the deaths from suicide, drug overdose, delayed medical care, ulcers and other stress related sicknesses, and abuse are enough, they will offset those numbers

Not if they get counted as a COVID death. You better believe that drug overdose death is getting a test if there's federal reimbursement in play.


> all kinds

I recognize that you're making a joke here, but that's categorically not true. Mental-health related deaths have gone up, and will continue to go up. A lot.


We could always lock everyone up in individual units, with no means to suicide because we would control all the tools they get access to for their own safety, and they can get two meals a day delivered to their door. The delivery person puts the ration down, rings a bell and steps away. The person inside a unit picks up their ration. And we can arrange for people to volunteer to help with making those rations and deliveries -- they would want to get out of their unit for an hour a day, so they can be productive during that hour.

Ok, i'm only being mildly sarcastic. Flashbacks from stories told by a grandfather and father. Honestly, if someone told me last year I would be typing this in a discussion on HN on this topic I would have told them they were insane. And here we are, people on HN actually discussing "stay at home" as if it was a not a big deal.

These are the people who work for Google and Facebook and Instagram and Twitter? It horrifies me. It should terrify the population.


It's real world political game theory. The unspoken side benefit (whether intentional or not) here is to limit the government liability in case of health related lawsuits in the future related to opening too soon, which is great as a state taxpayer.

Hesitate to bring it up since its so contentious but this is actually probably a huge side benefit of the Alameda County go slow approach. For the interim county health advisor, there's no benefit for going out on a limb and providing the rubber stamp to allow a plant to open as they'd ultimately individually be scape-goated if things went wrong. All politicians above would be free to claim - "I wasn't consulted on such details". Now since the plant is open without full approvals, all legal liability is on the private company for any health issues that arise. In fact the state hasn't really officially said the plant could open and so is free from liability and now that the president has chimed in, the interim county health advisor is completely free from liability.

It's a great get out of jail free card, release from liability stance as the individual or company is against government orders.


> The unspoken side benefit (whether intentional or not) here is to limit the government liability

If the government wants to limit its liability it should stop telling people what to do and let them decide for themselves.

> For the interim county health advisor, there's no benefit for going out on a limb and providing the rubber stamp to allow a plant to open as they'd ultimately individually be scape-goated if things went wrong.

So the only alternative is for the government, after imposing the costs of the lockdown on everybody, to simply refuse to accept the costs of reopening?


There's still some liability on the state in leaving it interpretable. They will also be called out for lack of leadership if they don't provide guidance.

The best political safe alternative for all players involved is to do what's happening now; the government provides a hard line on guidance and then is lax on enforcement and lets the plant re-open and begin production. If it goes well (and hopefully it goes well), it goes well.

If it doesn't go well, then people who were advocating taking the risk and with the most to gain if had it gone well, are ultimately responsible for the downside liability. Which seems fair?


> They will also be called out for lack of leadership if they don't provide guidance.

Called out by whom? I won't. I don't expect the government to provide me guidance. I'm an adult human being and I don't need a parent.

> The best political safe alternative

I have no interest in a "political safe alternative". Politicians worrying more about their political safety than the good of the people is what got us into this mess. Without a culture of "political safe alternative" the FDA would not have had the power to keep state and local health authorities from coming up with their own testing protocols when it was clear the FDA and the CDC weren't up to the job. And without a culture of too many people waiting for "guidance" from the government, people would not have waited to take obvious common sense precautions against a possible pandemic until the government and the media told them to, way too late.

> Which seems fair?

I have no problem with people who decide for themselves what to do with their own lives having to live with the consequences.

What I have a problem with is someone else claiming the power to decide for me what I am allowed to do, and the only consequences to them if they screw up being "political".


The scenario as a taxpayer that's concerning is as follows:

1.) Individual (or Company) A does some potentially unsafe activity and the Government says hastily - "Great, sure; continue!" or doesn't provide any guidance (edited).

2.) Individual (or Company) B is affected negatively - so negatively in fact that they decide to sue not only Individual (or Company) A but the Government as well since the Government said everything was on the up and up either through explicit approval or inaction (i.e. Individual B thinks the Government should have acted) - (edited).

The Government then loses the lawsuit and uses taxpayer money to pay the settlement. Then Taxpayer A, B and C proceed to also sue the government due to gross mismanagement of tax payer dollars and the government loses that as well. And now the rest of us Taxpayers D thru Z have to pay for all these settlements.


> Individual (or Company) A does some potentially unsafe activity and the Government says hastily - "Great, sure; continue!"

Who gave the government the power to make that decision unilaterally?

> Individual (or Company) B is affected negatively - so negatively in fact that they decide to sue not only Individual (or Company) A but the Government as well since the Government said everything was on the up and up.

So if the government were out of the picture, B would simply be suing A. There would be nobody else to sue. And the taxpayers would not have to pay anything.

So what value, exactly, is the government adding here?


You are just completely wrong and have no clue how liability works in US civil courts. Did you get your legal education by watching TV?


Clearly a large number of adults do require guidance, and health care practitioners are paying the price for their arrogance.


> Clearly a large number of adults do require guidance

So I should have my freedom restricted because other people can't handle theirs responsibly?


That’s what happens in pandemics: everyone’s freedom is restricted because everyone’s choices impact everyone else in serious, often fatal, ways.


> everyone’s choices impact everyone else in serious, often fatal, ways

No, some people's choices impact some other people in serious, often fatal ways.

My wife and I started taking precautions more than two months ago. We have drastically cut down the number of shopping trips we make--one of us used to go to the grocery store, drugstore, or whatever every other day or so, now it's about once every 10 days, and we make sure to stock up so we don't have to go more often. We wear mask and gloves whenever we do go to the store or any other public place where we can't reliably social distance. When we walk our dogs, we stay well away from anyone else.

How have our choices impacted anyone else negatively?


You have voluntarily restricted your own freedoms, so I’m not sure what we’re arguing about.


> You have voluntarily restricted your own freedoms

No, I've exercised my own freedom to choose what's best for me.

> I’m not sure what we’re arguing about.

First, you made an obviously wrong factual claim, so I called you on it. It is not true that "everyone’s choices impact everyone else in serious, often fatal, ways".

Second, this wrong factual claim is not harmless, because, as you yourself note, it is being used as justification for the government to exercise draconian powers to restrict everyone's freedom. The government cannot be trusted to exercise such powers responsibly. No government can, because governments are run by humans, and no humans can be trusted with that much power over other humans. That was supposed to be the key lesson that got the United States of America started as an independent country, but we seem to have forgotten it.


Governments enjoy legal immunity for policy decisions. There is zero legal basis to establish liability.


Florida, or Japan (with March photos of crowds enjoying cherry blossoms), or Sweden.


> What’s the goal?

A 14 day decline in new cases while maintaining a testing rate 200/100,000.


Hasn't it already been demonstrated that it is impossible to test at these numbers? Furthermore, due to relaxed mnufacturing requirements, something like 50% of the tests are completely unreliable/inaccurate?


It's only impossible in the us because we have a failure at the federal level. South Korea, Taiwan, Israel have better testing than the US. Even China can test to it's hearts content. Not us, because we aren't even trying collectively. In Washington State there was an article in the Seattle Times about the national guard having 30 people manually putting test kits together. Why aren't they making them in a factory? Because we aren't organized enough, we don't have supplies, etc.


South Korea has been testing less people than the US no matter how you slice it - per-capita or total, all-time or current testing rate - either way the US is doing more Covid-19 tests. (And as far as I can tell, Taiwan has tested far less people than South Korea in turn.) The US media has just managed to convince people that the opposite is true. It's not even close either - 14 per thousand in South Korea versus 30 per thousand in the US apparently[1], and current testing rate has even more of a gap. If there's some criteria for the testing rate that the US or any part of it isn't meeting, it's a safe bet that South Korea or most other countries aren't either - even all other countries for some of the more extreme ones being pushed by the media.

A number of people on here have made this claim, and every time I try and point out that it's the complete and exact opposite of the truth it gets downvoted. It seems to be something everyone on HN firmly believes. Maybe I should give up? Trying to get coronavirus testing-related comparisons to bear any resemblance to actual numbers feels more and more like eternally tilting at windmills.

(Admittedly, the media has done a good job on this one. There was even a really bizarre, cynical part in the last Trump press conference where he claimed that all US states are now testing more than South Korea and a reporter accused him of making "this a global competition", as though it was him and not the press that had been pushing this comparison - and all the media discussion became about his row with that journalist, ensuring that no-one heard about the underlying facts and updated their false belief that the US was behind South Korea in testing due to the federal government fucking up. Masterfully done. Practically Trumpian.)

Now, Israel is genuinely doing more testing than the US, but you'd kind of hope for that from a much smaller country with a big globally-relevant pharmaceutical industry.

[1] https://www.worldometers.info/coronavirus/


Exactly. So it’s an unattainable pipe-dream metric. This is more reason to stop spouting these numbers to people as the “official target for reopening”


It's impossible to test at these numbers today, but there is no technical reason that it can't be achieved in the future.

And the quality issues can be solved as well, it just makes point one even worse -- it'll be that much harder to maintain the testing rate and the quality.

But they are achievable goals.


It is. People are still getting sick. They are dying in greater numbers. They are getting Vitamin D which actually helps with fighting. But they are mildly discomforted.


The connection between influx of new COVID cases, deaths, and safe-from-home is pretty clear from looking at the daily new cases, which flattened exactly two weeks after lockdown began. Look here at the general US statistics: https://covid19info.live/us/


I don't know the goal, but I see plenty indirect benefits in lockdowns around the world, and hope they'll happen more often, like for a heatwave or a pollution peak, to give nature a needed break


They have established objective metrics to use in determining when to loosen restrictions, and there are also procedures in place for partial reopening of restaurants, recreation areas, etc. Your questions are answered in the article.


I feel like this just needs a better branding. For one thing, across California the stay at home orders have barely been enforced anyway. People are hanging out in parks, even meeting up with friends in parks all the time. So it's been an open secret this whole time that it's more voluntary than an "order". Now with curbside pickup, and restaurants partially opening, it seems like taking another step towards more targeted interventions and away from the broadest stay at home orders.

This all seems in line with what anyone would have expected. Anyone who thought that on June 1 when the stay-at-home orders officially end everyone would just jump back into normal life and it would magically be safe clearly hasn't been paying attention.

The difference between California and states like Georgia that have "opened up" actually seems to be quite minimal. Some people are taking more risks (which is not really being stopped in either place), the majority are still being very cautious. That's bad news for people hoping that the small businesses that have been financially hurt would spring back immediately, but hopefully good news for where we are in containment of the virus. And, knock on wood, at least for now it seems to be enough to keep the disease spread from ramping back up.

I still think it would have been nice to just go all the way with the lockdown from day 1 back in March, actually enforce the rules and keep more people inside, and squashed the curve faster so that by now we'd be a lot more open than we are. But instead we chose the route of making most people only moderately miserable instead for a long time, instead of even slightly more miserable but for a shorter time.


The bar is extremely high. No deaths for 14 days? That seems almost impossible.


As somebody who has worked in a "data driven" environment, I look forward to health departments re-discovering Goodhart's Law [1]

[1] https://en.wikipedia.org/wiki/Goodhart%27s_law


In this case though, I think it’s okay to have the measure be the target. If people can self-regulate their behavior to fit a certain rate of infection, what’s wrong with that?

(Not to mention the infection rate is a really lagging indicator)


Well, the metric is really no reported deaths...


The goal is to stabilize the infection rate and boost healthcare capacity so that some semblance of normality can be resumed without overwhelming the healthcare system.

> a lockdown for such a long time is crazy.

And people will rebel, and the infection rate will spike yet again, and people will die, and the lockdowns will be imposed with force.

Better to listen and understand than to disobey and risk worse. What's the expression? Regulations are written with blood?


> The goal is to stabilize the infection rate and boost healthcare capacity so that some semblance of normality can be resumed without overwhelming the healthcare system.

meanwhile... https://news.ycombinator.com/item?id=23115056


Everytime someone posts something along these lines I am reminded how difficult it is to get a sense of exponential growth & how the gap between needing them, not needing them, being overwhelmed, having this blow over is a smaller than it intuitively feels.


Yeah, wish we had used them, and not wasted the potential /s


The minute this disease hit the US, 0.3% of the population was immediately living on borrowed time. The goal of the lockdowns was to keep that 0.3% from rising to 3% because of overwhelmed medical services. For most of the country it's worked, but there's nothing you can do to save the 0.3%, and inciting the country to riot is only going to add to the toll.


> For most of the country it's worked

Do you have something that reinforces this? JHU dashboard data extrapolation (https://coronavirus.jhu.edu/us-map) and revised models (https://www.livescience.com/trump-administration-models-pred...) starkly disagree.


Check out IHME, https://covid19.healthdata.org/united-states-of-america. They currently estimate 145k but it swings as states open or close.

If people mill about and it doesn't stop till we reach herd immunity, imagine at 50% of pop, 0.3 or 0.5% die, that's a big number 330mil * .05 * 0.005 = 825k deaths. IHME estimates assume we won't just keep standing around until half of us get it. The fools walking around are competing with that vision.


Ok, did not realize national hadn't leveled out, so I take back 'most'. I feel like my state's (CO) re-opening response is appropriate but we've been relatively 'flat' for a couple weeks. Apparently we're also one of the few states that can afford a Tableau license, we've had a decent site https://covid19.colorado.gov/data/case-data since March.


There's multiple promising therapeutic treatments going through high quality studies and vaccines aren't impossible.

Why so defeatist?

Also, there's mounting evidence that social distancing is being done socially (by people making their own choices) as much or more than by governments.


It's not defeatist- vaccines and treatments take time, implementing contact tracing takes time. But pushing for unrealistic outcomes is just going to lead to distrust and lack of preparation for the next event when they inevitably fail.


A nitpick, but I fear that we're not boosting the healthcare capacity... whether due to healthcare still being profit-seeking here, or due to the Fed Govt being completely inept.

In which case it's easy to feel like it's all for nothing.

I personally still support it but I can see why people are frustrated, and I think as this goes on you can't just extend it without some really clear and transparent communication.


>people will rebel, and the infection rate will spike yet again

that is unknown. If anything, the flu experience shows that the hot dry air minimizes transmission by minimizing the lifetime of the exhaled aerosol mini droplets which carry the virus.

The rate will most probably spike again in the Fall, lockdown or no lockdown, because of the colder moist air then, and I think it is very misleading to promise people the lockdown avoidance later in exchange for a larger lockdown now.

Governments at all levels seem to be doing only lockdown, which basically means doing nothing by the governments themselves and just putting the burden squarely on the people shoulders and waiting hoping that the issue resolves on its own. Where are the true government actions to fight pandemic - i mean at least bare minimum - masks, testing, contact tracing? Why Whole Foods, not the government, should give away free masks? I guess, no money for masks in the $6T dollars that have just been printed and have propelled the stock market back into the bubble.


right, that's why no one in Australia or Israel or other hot countries got it, like India. But that was a sarcastic comment. It is spreading in hot places. It's a lot more reducing exposure that limits it than hot weather, based on reality, not magical thinking.


So far all I've seen on this topic are mostly models.

I'd love some experimental data for once (with regards to SARS-CoV-2, a lot is modeling, and a lot less is bench work) to know if this is true or not (there are a few studies but most of them aren't that great, at least the ones I've read).


“Where are the true government actions to fight pandemic - i mean at least bare minimum - masks, testing, contact tracing?”

Very true. There should be no shortages of tests, masks or other protective equipment. Instead the stock market is going up.


> the lockdowns will be imposed with force.

"Comply or be killed" will be an interesting order, I look forward to seeing that one go out.


As much as cops may like to escalate right to the shooting at times, there are a lot of possible levels of force before being shot.

Civil tickets. Revocation of business licenses. Fines. Arrests. Tear gas.


In this particular case, the prevailing political affiliation among cops is more likely to push them in the other direction, e.g.:

https://www.seattletimes.com/seattle-news/port-of-seattle-pl...


And to minimize the exposure risk to our boys in blue, we'll put ED-209s on every street corner.


I’d buy THAT for a dollar!


Singapore is already testing a Boston Dynamics bot to, basically, yell at people violating lockdown.


I'm genuinely concerned about rioting.

Many of my childhood friends (living in LA) have already been incredibly angry at measures before this came out, and many other protests have already been seen.

It seems strange to me to not try to do a partial reopening of businesses that can guarantee social distancing guidelines -- and yet they're reopening recreational activities, including the beach. This feels back-asswards, and I really hope it works out well, but I think they need to think this through really carefully.


I firmly believe it's coming.. There's no way people are going to keep going along with it into summer, especially if the number of cases isn't growing or feels distant.


Wait until people find out that 50-70% of the population is fully expected to get infected anyway.


I don't think this has sunk in yet for most people. We can be thankful that the disease is barely any more deadly than an average flu.

Here in Korea, some clubs were reopened and abrutly reclosed because of a spike in coronavirus cases linked to club. This totally confuses the objective. "Flattening the curve" is one thing, and "keeping everything closed until there is zero transmission ever again" is something else. It seems to me that the disease will be with us possibly forever. Whether we reopen today or 6 months from now. If LA County et al have this firm requirement of zero transmission to qualify for reopening:

(1) This is not "flattening the curve" (2) This threshold may possibly never be reached


> is barely any more deadly than an average flu. This is heavily debated and the most optimistic of those estimates it at 10x worse -- current reported numbers are closer to 15-20x worse. NYs current mortality rate for this year compared to the flu is 21x: https://www.medpagetoday.com/infectiousdisease/covid19/86176

In addition, a lot of people aren't talking about the fact that this seemingly has left a lot of people with significantly longer lung problems: https://www.hopkinsmedicine.org/health/conditions-and-diseas...


There is a study for every truth. There are plenty of other data showing it is hardly dangerous. Also, so many deaths are being counted as covid when the patient already had a severe condition - Dr Birx and many other public health officials have made this clear, too. The numbers are way inflated.


"there are plenty of other data" -- would you be able to educate with some sources? I've been digging in deep and trying to keep an impartial opinion, but have not seen solid evidence that this is true -- or, as you say "there is a study for every truth", I've seen no study to indicate "it is hardly dangerous" (which also feels subjective in those words)

> Also, so many deaths are being counted as covid when the patient already had a severe condition

Yes... as many scientists talk about, COVID-19 has a much more severe effect in people with underlying conditions. Here is where Dr. Fauci, or the CDC as a whole talks specifically about underlying issues: https://www.cdc.gov/.../hcp/underlying-conditions.html

"the numbers are way inflated" is using generalized language for something that might be true, but even if you take a _very_ conservative view and consider 50% of the reports are false (and I've seen nowhere claiming it's anywhere near that high), the 50% of remaining deaths and complications are significantly high enough that it's far worse than the flu, and far worse if lockdown wasn't in play where some basic math indicates it would be 10x worse: https://www.youtube.com/watch?v=Kas0tIxDvrg


Given that even "regular" pneumonia has effects that can last months or even a year, it is too soon to draw conclusions in one way or the other.


Flu is also vaccinated against among the most vulnerable.


It's barely more deadly than the average flu when viewed across the entire population, but to the part of the population in a nursing home, it's basically like ebola. There have been multiple nursing homes just in my state that are seeing death rates between 20 and 40 percent, which is just bonkers.


Over here on the East coast of the US we're looking at Cali and saying "they did it right." "People" are blaming NY on the fact that a lot of people arrive their from foreign ports (air and other)- completely oblivious to the fact that if you are coming from China SF and LA are also destinations-and maybe preferable for flights.

It's really a case that because they contained it so well it looks like they didn't need to. Kudos.


Neither LA or SF have the subway that resembles Tokyo in how busy it is but has nothing in common with Tokyo in how clean it is.


I can see this easily. Unemployment is insurance—it’s not designed for more than a small number of people actually using it at once. Once that money is gone, and the federal unemployment backup fund is gone, and the food bank has to turn people away, a good number of them will steal in order to eat.


I'm concerned about people wearing masks being targeted.

We've already seen some of that early on, but it was before masks were broadly recommended, and was tied into anti-Asian racism. This time, I'm worried that masks are rapidly becoming the visible, prominent symbol of social distancing etc; there's already active pushback against them, and attempts to enforce them, to the point of extreme violence. At some point, merely wearing them around people who do not do so, becomes an unwelcome reminder to those people, even if you're really only wearing it for safety reasons.


Did you read the article? Because your concerns are addressed. The beaches are planned to reopen soon, and there are procedures in place for partial reopening of some businesses.


The fact you have to ask this question is the answer, of course the OP did not read the article.


True, but the article title could have reflected the contents much better.


Yeah definitely click baity.


Admittedly, I had skimmed parts of the article, though it seems like you didn't read my message either. I mentioned in my original message that the beaches were being reopened soon... so unsure why you're drawing attention to it again.

I had missed that they are planning to reopen some businesses: > Under the plan, some in-restaurant dining, car washes and shopping malls could also be allowed to reopen in coming weeks if public health officials in a county are able to demonstrate that the spread of the virus has stabilized and that they have adequate testing and hospital capacity.

Specifically: "dining, car washes and shopping malls could"

These are _not_ the type of businesses I was referring to. I meant more along the lines of factories, and other "not quite essential, but maybe essential" such as dental offices.


Not the parent but I am not paying $98 to read the story.... So no I did not, maybe people should post links only to non-pay walled sources


[flagged]


I have no idea what it is, but it seems like a conspiracy channel. https://www.youtube.com/watch?v=xmoTebYF90w


What is wrong about the video? It's just criticizing Bill Gates paternalistic and misguided command of public health from the Gates Foundation.

Edit: I am not endorsing the channel, but this video seemed reasonable and didn't describe any conspiracy that wasn't well known (Microsoft anti trust).


we'd clearly be waay better off with no organizations trying to figure out what's happening. The seattle flu study is a terrible thing (which started testing covid-19).

The us federal govt has abrogated much of its responsibility, our only hope at this stage is local/state govts and ngos. These paranoid people things that bill gates is coming for their precious bodily fluids is sad but predictable.


indie journalist


Looks like a lot of conspiracy theories though?


The content speaks for itself. Turn on your bullshit meter and dive in!


This looks a lot more like a conspiracy blog than anything else.


I would like to get an official explanation for two things: 1) What is the goal(s) of the "stay-at-home" order? 2) How well it is achieved compared to other counties/countries with different policies?


1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy.

2. Thus far, it's worked to keep hospitals functioning. We're doing worse than most other countries (https://91-divoc.com/pages/covid-visualization/).


>> 1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy.

Very few regions have had anything close to overwhelmed hospitals. More regions have had to lay off hospital staff than have been overwhelmed. Some like UW medicine now face a $500 million budget shortfall due to the ban on elective procedures.

Social distancing measures may have an effect on r_t as low as 0.1 per analysis by Nate Silver. Others show a negative or no correlation between government lockdowns and reduction of r_t.

It is fair to question if these lockdowns - as instituted - have done anything.


> More regions have had to lay off hospital staff than have been overwhelmed.

That's a bit of a red herring. Hospitals aren't laying off ER and ICU staff. They're furloughing in areas like dermatology, plastic surgery, and the like - parts of the hospital that see largely elective procedures.


> furloughing in areas like dermatology, plastic surgery, and the like

Stop. This is incredibly misleading.

Elective just means that you can choose the time to do the surgery. It doesn't mean they are optional for health.

Elective surgeries include inguinal hernia surgery, cataract surgery, mastectomy for breast cancer, kidney transplant, and hip surgery.

Most surgeries are elective.

Don't minimize this as a bunch of delayed facelifts.


I'd be happy to wager there are substantially more dermatology visits in your average hospital than there are kidney transplants.

There's a range of severity in "elective" procedures, certainly. There are a lot of procedures folks will willingly postpone right now, and it's not surprising that hospitals are furloughing staff that service them.

It is disingenuous to suggest that furloughs in these elective areas demonstrate an excess of capacity in the ER/ICU.


Dermatology is real medicine with real consequences. Even Jerry Seinfeld found out the hard way: https://youtu.be/EmzM0bz3PWc


Certainly, but you'll likely find it has a higher proportion of elective procedures that can be held off than, say, the NICU.

Which will mean that department's staff - docs, nurses, receptionists, billers, cleaners, etc. - will be more likely to be on the furlough lists than the ER or ICU.


You are making a lot assumptions about what is / isn't considered elective based on your own personal priors/biases. Look at this list:

https://www.hcup-us.ahrq.gov/reports/statbriefs/sb186-Operat...

Knee replacements, hip replacements, even Coronary artery bypass graft can be considered "elective" if there is not an urgent need.


Focusing on hospital stays misses an enormous aspect of what hospitals do; routine visits, outpatient procedures, etc. There are plenty of reasons one might visit a hospital for something elective that doesn't show up as a "hospital stay" from that link.

My kids get eye exams at the hospital. My son's allergist is there. These visits can wait, and they make up a lot of a hospital's business; the staff in those areas have little to do at the moment.


Kidney transplants are considered essential surgery, not elective procedures according to the DHHS. [1] I would be incredibly surprised if any other transplant surgery was considered elective since time is usually of the essence in transplants.

[1] “We are grateful to the Administration for clarifying that transplantations are an essential surgery which can be performed safely if a hospital feels they have the staff and resources available during the COVID-19 crisis,” said Joseph Vassalotti, MD, Chief Medical Officer, National Kidney Foundation. https://www.kidney.org/news/national-kidney-foundation-urges...


You've completely missed the point that elective does not mean non-essential.


And you've argued in bad faith by using an emotionally charged procedure as "evidence" for your argument.


As someone with a pregnant wife, I'd also like to mention that birthing classes, breastfeeding classes, etc. are also not available at the moment.

My wife has had to "visit" an OB/GYN over Zoom.

I don't know how effective or not midwives and such are (I really should get on that...) but women are having to go without them or choose to go without having fathers by their sides. Some places have stopped any visitors from being present.

There are potentially long term health impacts from the above changes, I'd imagine.

Not all of what a hospital deals with is immediately life threatening, though putting it off can certainly make it so.


A midwife is a person who delivers the baby. Maybe you're thinking of doulas? If so, New York indicated doulas wouldn't be counted as visitors, but essential healthcare staff ( https://www.governor.ny.gov/news/secretary-governor-melissa-... ); it's worth looking up how your state and/or hospital is handling this. NY also apparently settled on "dads can attend, but should plan to stay in the hospital rather than popping in and out". ( https://gothamist.com/news/all-ny-hospitals-must-now-let-par... )

Hospitals are rightly trying to figure out what rules make sense. It's not surprising there's some uncertainty, and adjustments will be made as we learn more.


> Maybe you're thinking of doulas?

Yes, that's right -- sorry for the mix up.

> If so, New York indicated doulas wouldn't be counted as visitors, but essential healthcare staff

Thanks for sharing, but that's seemingly not the policy in the actual hospitals that I can see.

From NYU Langone's visitor policy (https://nyulangone.org/patient-family-support/visiting-hours):

> Labor and delivery patients are permitted one visitor throughout the labor, delivery, and postpartum period, which can include a partner, family member, doula, or other support person. The visitor cannot be rotated.

It seems like there is no option to have both a doula and the father present.

I honestly have no idea if we would even use a doula--I've done approximately zero research into them at this point--but it's a pretty hard choice to make at the moment.


> $500 million budget shortfall due to the ban on elective procedures.

I feel like that's a symptom of a much larger problem...


It looks like all of LA County has about 30 empty ICU beds today. To me that seems pretty low (although not "overwhelmed").


The entire hospital staff doesn't just sit around waiting for a pandemic. Most elective procedures have been postponed during this. Large portions of the healthcare system are idle _because_ everyone is at home. The parts of the hospital that can handle the symptoms of the virus are what we're trying to reduce the burden on.


> 1. To flatten the infection curve, in order to keep healthcare systems from becoming overwhelmed like those in northern Italy.

I could buy this line of reasoning if there was any indication that hospitals outside of NYC were at any point “whelmed”, nevermind “overwhelmed.” All across the country you’ve got doctors and nurses getting their hours cut, furloughed, and laid off. And the ones who actually are in the hospitals have enough time to coordinate elaborate dance videos on TikTok.


Not every doctor exists to respond to an acute respiratory viral infection.

Also, I don't think you can accurately determine the workload of a nurse based on a 30 second tiktok video. You know, I saw some truckers sleeping for a few hours at a truck stop on the highway. Why aren't they driving to deliver their packages? Clearly they have plenty of time.

An overloaded _system_ does not necessarily result in overloaded _workers_. In fact, it should minimize the number of overloaded workers as much as possible to avoid preventable mistakes. Taking some time to film a fun video with your coworkers should be viewed as workers taking necessary time to unwind, not as workers taking unnecessary time to goof off.


> Not every doctor exists to respond to an acute respiratory viral infection.

When you disallow elective procedures and everyone else stays away from hospitals for fear of catching the disease, they kinda do.


Ok sure, and I bet a lot of the _people_ want to help.

But another limiting factor is the facilities with which they work. When I say "not every doctor" I don't just refer to the warm body that went to medical school, I'm talking about the doctor and the facilities they use to perform their duties. A podiatrist's office can't just turn into a COVID ICU overnight, however willing or able that podiatrist may be to lend a helping hand.


That's the nature of exponential growth. Becoming overwhelmed happens very quickly. Successful mitigation almost always looks like an overreaction.


Do you think anyone in their wildest dreams back in March imagined that hospitals all over the country would look like ghost towns? I’m pretty sure we were expecting hospitals to at the very least be experiencing high loads in the midst of these lockdowns.

You know, it IS possible for both “lockdowns work” and “the models and experts were a bit off base” to be correct.


It's not surprising the models weren't perfect in the first go-around. It's good they were flawed in this direction, and I'm glad hospitals aren't collapsing as a result.

I hope we don't overcorrect, open up too soon and too much, and get to see what the other side of getting it wrong looks like.


That link you provided doesn't look like its taking into account the population size of those countries. The US has ~330 million people.

For example, Russia looks like its #2 on the page but Russia has less than half the population of the US. If you look at per capita Russia would be above the US according to your graph.


The more important aspects of that chart than raw case numbers are a) how long does it take to flatten the curve and b) is the curve coming back down.

(There's also one further down, "normalized by country population", in which we still don't look great.)


I didn't scroll down all the way so I didn't see the normalized chart. Thanks for that.

I think that the number of cases which is the default isn't all that important. In fact the higher number who are infected could make herd immunity happen sooner. The number of deaths is far more important. When you look at that on your chart the US is behind many Western European countries and it definitely doesn't look as bad. Its not great but it could be worse.

Do you have a chart that is looking at population density? I think that would also be a useful comparison when comparing different areas. Its not fair to compare NYC with Nebraska for example. I am not really sure how the European countries compare and am interested in a comparison if you know of one.


1 is insufficiently clear. Is the endgame 1) getting new infections down to such a small number that they can be individually detected and isolated, 2) keeping hospital utilization from overrunning capacity while allowing the population to reach herd immunity, or 3) staying in lockdown until we have a vaccine or cure?

Until this question is answered clearly and officials show that whatever goal they set is achievable in a reasonable timeframe, I think it’s unreasonable to expect people to continue to comply.


#1 likely isn't possible in the US.

The actions you take for #2 and #3 are similar, and which one you wind up implementing depends largely on how long the vaccine takes to develop.


I agree that 1 seems impossible. I think 3 is impossible without complete economic and social collapse. 2 would involve loosening restrictions and allowing spread that doesn’t quite max out capacity. It looks like 2 is functionally what the states are going to pursue, while no one admits it out loud, and the people who thought we were doing #1 express horror.

Edited: meant to say states are doing 2 (comment initially said they are doing 3)


No reason you can't do #2 while waiting for #3 to work.


The longer you do #2, the less you need #3, if the goal of #2 is to keep hospitals being utilized at the highest sustainable capacity with whatever safety margins are required.

As more people become immune, the spread naturally gets slower, reducing the likelihood of hospitals being overwhelmed in the first place and thus reducing the desire to maintain stricter control. The individual risk of any given social interaction is reduced.

Conversely, the more infected, the more dead, meaning the number of life-years that would be saved via a stricter lockdown until a vaccine or effective treatment gets developed gets smaller and smaller.

I believe the shortest time it has taken to develop a new vaccine is the 5 years it took to develop one for Ebola, so I don't think one will be available in any meaningful way for this pandemic, though I'd love to be wrong.


Most of the companies and universities working on vaccines have experience on earlier coronaviruses: for example Moderna and the Jenner Institute / Vaccitech worked previously with MERS vaccines. So they're not starting from scratch.

Other companies like Sinovac have also been doing challenge testing already (I believe Oxford too, but AFAICS they haven't published anything yet) in animals, so far with good results. EDIT: Sinovac findings were a preprint, but now it's been published in Science, so I guess it has more weight.

Also to speed up trials, Oxford is doing a hybrid Phase II / Phase III trial, hoping to get emergency use authorization in September if vaccine responses are positive.

Lastly, most companies and consortia are ramping up manufacturing at-risk (because there's no guarantee vaccines will work) to make sure the demand is met earlier.

So it is likely that if a vaccine works, it will be around earlier than before. Whether everyone will be able to have it, is a different matter entirely.


> What is the goal(s) of the "stay-at-home" order?

This is my biggest complaint. The press briefings and the media have been worthless for trying to figure this out. I want to now the exact plan and I realize it will need to adapt over time but that should be explained by the plan. All the White House wants to talk about is the economy. I just want to know, are we going to wait for everyone to get vaccinated or tested for antibodies? How is the progress on those things? I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that.

Or is our goal to fully go to 0 new cases and just hope it doesn't pop up again. That seems unlikely since I don't know how that's possible without a complete lockdown for at least two weeks. Also, is there any possibility that this just goes away on its own?

Saying we're opening things up just because of the economy seems completely moronic to me. I want to know what the actual plan is. Everything seems just arbitrary right now.


> I don't care if some idiot who's not a doctor thinks some malaria drugs might help because he stands to benefit from that.

Not everyone is this shady. There's a real trial (University of Minnesota) trying to determine if HCQ works or not as post-exposure prophylaxis. Sadly, it only needs 150ish more people but it's struggling to get them (at least according to its PI).


This is the best response. We know the answer to #1 from the feds earlier on, but we need to make sure states and cities are on the same page.

There is no way to prevent all death. We won't and can't get to zero deaths in the short term - testing, tracing and vaccines are all far out from useful yet.

Given that we don't have a government like Denmark, that can support all workers staying at home with job security, we have the tough choice of "rot at home and lose our jobs and businesses" or "take some risk, try to be smart, and keep hospitals from getting slammed".

Protect the old and the immuno-compromised, and give them the support they need. Mandate mask use in crowded areas until we hit certain non-pandemic levels of new infection. Continue heightened production of PPE, sanitizer, etc. and work to allow small-medium in-person gatherings to be feasible again.

If we do have large events, or open nightclubs, I could see requiring contact tracing apps. Like, give us your name/number so if you get infected, we know about it and can track it; if we(the club) cause an outbreak, we can notify people.

But we can't sit at home much longer, financially or psychologically.


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