China is following a strategy of shutting down everything and getting R0 as low as possible. This works well in the short term, but they either have to keep everything shut down forever, or risk the whole thing starting over again.

UK is following a strategy of shutting down only the highest-risk people, and letting the infection burn itself out. It's a permanent solution, but it's going to be really awful for a while as the hospitals overload and many people die from lack of hospital care.

What about a strategy in between these two? Shut everythin... (read more)

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9Self-Embedded Agent19dJust like to chime in to say that this (=' flattening the curve/ herd immunity') fundamentally doesn't work, and you don't need to have a PhD in epidemiology from Imperial College to understand this [but you might need a PhD in epidemiology to misunderstand it], just basic arithmetic and common sense. Suppose 50% of the UK (33 million people) get the virus of which 5% (~ 1.8 million people) will need serious hospitalization [conservative estimate]. The current capacity of ICU beds in the UK is something on the order of 2000 beds , depending on occupancy rates, ability to scale up et cetera. Let's be extremely optimistic and somehow the UK is able to quintuple this capacity [as far as I can tell this is unlikely]. When somebody is sick they might need care for 2 weeks. The annual hospital capacity is: 25 weeks * 10.000 beds= 250k. At the moment the capacity is nowhere that (perhaps 50-100k). You can see that 1.8 million is far larger than 100k or even 250 k. Even wildly optimistic estimates will not yield anything realistic. This assumes that the government is somehow able to control the infection spreading over a year; instead of two months. There is no reason to think they can do this without extreme (partial) lockdown measures. Controlling the R0 is extremely hard. All the mild measures seem to help only a tiny little bit. If the R0 is only a bit over 1, we still have exponential growth; and you have merely pushed timelines back a few months. Can we perhaps expose young people but lock up older people for one-two years [when the vaccin might arrive]? I find this is extremely unlikely; you need only a couple people to flout the rules to wipe out an entire nursing home. Is it worth it to (partially) lock down the entire country for a year to save maybe a hundred thousand old people? There are only two real possible approaches: 1. Let the Boomers die. If we're lucky the death rate is ~0.7 percent. When (not if) hospitals overflow this will easily triple.

I agree with this analysis completely.

There is a strategy bifurcation: Either you lock down hard and contain/eradicate, or you just accept the losses and tell people to go on as normal, with isolation of the vulnerable.

The middle path is not favorable. You take both the human damage and the economic damage.

4Jackson L19dYes you are correct, succinctly addressed here " They ignore standard Contact Tracing [2] allowing isolation of infected prior to symptoms. They also ignore door-to-door monitoring to identify cases with symptoms [3]. Their conclusions that there will be resurgent outbreaks are wrong. After a few weeks of lockdown almost all infectious people are identified and their contacts are isolated prior to symptoms and cannot infect others [4]. " https://necsi.edu/review-of-ferguson-et-al-impact-of-non-pharmaceutical-interventions [https://necsi.edu/review-of-ferguson-et-al-impact-of-non-pharmaceutical-interventions]

March Coronavirus Open Thread

by Elizabeth 1 min read8th Mar 2020374 comments

58


This thread was created on 3/8/2020, or approximately one million years ago in virus time. It’s getting pretty bloated now, and a lot of things that were high value at the time have been eclipsed by events, making karma not a very useful sorting tool. So I’m declaring this thread finished, and asking everyone to move over to the April Coronavirus Open Thread.

Interested in what happened in this thread? Here’s the timeless or not-yet-eclipsed highlights:

  • Scott Alexander comes up with Hammer and Dance 6 days before Tomas Pueyo
  • Spiracular on why SARS-Cov-2 is unlikely to be lab-created.
  • Two documents collating estimates of basic epidemiological parameters, in response to this thread
  • Discussion on whether the tuberculosis vaccine provides protection against COVID-19.
  • Suggestive evidence that COVID-19 removes sense of taste and smell.
  • Could copper tape be net harmful?