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Does COVID-19 have a long "incubation period" because we don't have any immunity to it?

This is a "makes sense to me" idea I merely thought of, and I have 0 medical expertise. So this is probably dumb, but now that I've thought of it I keep wondering whether it's true.

My thinking is that the early symptom onset we feel when we get a cold or flu is partly down to our immune system responding, which causes inflammation etc. With the novel coronavirus, the immune system isn't responding early on, and the infection itself will be in the slow ramp stage of its exponential growth, so the infection is already well established by the time you start to feel it.

I mean...The same way we always do? It depends on whether the risks are reasonably forseeable. We know that if you go about your business as normal while infectious with the coronavirus, you might infect 4 people on average. If we take a lowish infection fatality rate and say that 0.1% of infected people die, then you have a something like a 0.4% chance of directly causing someone's death.

How bad is a 0.4% chance? Should the law tolerate people putting others in danger, at about that level? If you could load up a 200-barrel revolver, would it be okay to put one bullet in, spin and fire?

Here's one way to think about it: if you were to act such that you introduced a 0.4% chance of someone else dying every day for a year, there's a 23% chance someone would eventually die. So I would say, no, this is not a level of danger we can accept people to impose on non-consenting strangers.

In practice the way that I think the law normally works is, if your actions show a disregard for the welfare of others and someone is in fact harmed, then you can be held culpable. So if you go outside, someone catches coronavirus and dies, then you can be held responsible. By my crude calculation, there's about a 1/200 chance of that happening. I don't think most people would break quarantine if they knew there was a 1/200 chance of someone dying and them going to prison. I think just explaining that the law was seeing it that way makes them take the risks seriously, while as it currently stands, lots of people think it sounds like bullshit.

But quarantine isn't a punishment, nobody's saying the person being quarantined has done anything wrong. It's just that you've suddenly become extremely dangerous, and that means you have to change your behaviour quite extremely to avoid harming other people. That's very inconvenient, sure, but nobody's convenience gives them the right to put others in harms way.

I'm not a lawyer but criminal negligence is definitely a thing:

You can extend the same negligence standard further, though. You can tell people: check your temperature in the morning, and if you have a fever you are lethally dangerous. That facts of the situation we're in are such that, going outside with a fever really does burden other people with unconscionable risk. But we've left it for individual people to deduce that, which means we can't enforce that as a standard.

A law could be passed that said, if prosecution can show beyond a reasonable doubt that you either knew or did not care to know whether you had a fever when you left the house, and you left the house anyway, that that is sufficient to show a negligent disregard for others' safety. You'd then have to make an affirmative defence for why it was not actually negligent (for instance, you could argue that you'd have coronavirus before, or that it was reasonable to believe you could not encounter anyone).

A lot of drug laws work on sort of analogous logic: they define "trafficable quantities", such that showing you possess some amount of a drug is sufficient to argue you're distributing that drug, and then it's up to you to mount an affirmative defence that moves the balance of probability back in your favour. You're still assumed innocent of the fact of possession --- but the law is allowed to encode some inferences, once facts are established.

(Not a lawyer so potentially this isn't correct, but:) Legally negligence is a bit weird in that it doesn't really work probabilistically. If you actually cause the harm you suffer the culpability, but otherwise, maybe not. I do find it a bit unsatisfying, but I suppose the advantage is it's robust to the state being completely wrong about whether something is risky. In practice most people do adjust their behaviour to the potential downside for themselves, preventing the potential downside for others. But it does depend on the individual to make a rational risk calculation.

The extent of the negligence definitely matters. Not vaccinating your children isn't on the same planet of externalised risk as going outside with coronavirus. And passive smoking is several orders of magnitude lower externalised risk than failing to vaccinate your children.

My main point is that the argument needs to be made forcefully that there's a simple and unexceptional basis for requiring people to comply with quarantine. This isn't a strange situation where the state must grab additional power. Actually I've seen a lot of people say that libertarian theories of justice fail to account for this situation. I'm not a libertarian but I think it's important that we totally reject that take. That's not what's going on at all.

The situation must not be framed as one exceptional circumstance where the state gets to basically imprison you in order to force you to do it the favour of not walking around. That's completely not what's happening. Instead the strange facts of the situation are this: by walking around you might be causing people to die. We must make people understand this strange fact. If you recklessly say "I don't care I'm walking around anyway", and someone does in fact die, then you are culpable. For the vast majority of people, this will be enough to make them comply. If you know you're sick and you know that going outside might send you to prison for the rest of your life, why risk it?

I agree that actually eradicating influenza feels far-fetched. But on the other hand, it's quite a lot easier to work with than COVID-19. Influenza isn't nearly as infectious, most people have immunity, and it's barely transmissible at all when the carrier is asymptomatic.

Imagine you actually did have the "hazmat curtain" situation. Everyone is asked to take their temperature on the way in, and significant fines (and potential visa cancellations) are imposed if you lie. At first nearly everyone is checked to verify, but this is relaxed to spot-checks as people get used to never breaking the rule. Few enough people are getting sick that when people do report influenza symptoms, they can be tested, and contact tracing can be employed to halt the outbreak and trace it back to how it was introduced.

If there are no animal reservoirs for the disease, I think that could be viable? It's expensive, but influenza is a big cost in itself, in lost productivity and other problems.

The big problem I see for eradicating coronavirus will be in poorer countries --- Africa, the middle east, etc. The outbreaks there are still pretty small, but there's no real resources to address them, so the problem could grow there until it's really hard to fix.

Most tests you carry out on anyone else will be negative, so even if you think there's an 80-90% chance the patient is COVID-19 positive, you still get more information from running those tests than the lower symptomatic people.

Also, it does change all sorts of decisions. It probably changes what precautions the healthcare workers need to take, and it lets you tell the person's family to self-isolate. Otherwise the husband is in critical condition, and the wife might be a week behind, so she's in the waiting room making everyone sick.

But why can't we eradicate the virus? Let's say China shuts down international travel, keeps doing what they're doing, and then slowly eases back up in some area, letting the people in that city comingle and go back to work, but still restricting travel in and out. Let's say they get that city back running, with no coronavirus cases after a month.

At the same time...Won't they also have basically eradicated other influenza there? Even if not entirely, there should be much less cold and flu, right? So as soon as coronavirus creeps back in, it should be much easier to contain.

I guess my thinking here is, if coronavirus is much more virulent than the flu, and this type of containment works to almost eliminate the coronavirus, could China...actually eradicate the flu, at the same time? If not, why not?

The problem comes in from other countries. If China goes to all this effort and the US, Europe, UK etc don't, do we would end up with this weird hazmat curtain? Asian countries would join China in eradicating the disease, and Australia and New Zealand would probably join them.

I don't think I meant to imply that -- could you point out where I seem to be making that assumption?

Obviously there are more exploits for a computer running Windows 95 than a carefully firewalled Linux server.


Okay, I'll paste the content in. I think you're right -- a link post is pretty much strictly worse.

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