This is ignorant. The country is the size of a continent. Each subregion should be managed based on current and developing conditions, density of population, weather conditions, etc. Some states have zero deaths, presently and only a few dozen cases. Even China didn't shut down the whole country. Masks and fever checks along with testing should be enough to slow the spread without triggering Great Depression 2.
What makes you think that you are better informed on infectious diseases than the guy whose charity has been engaged with the issue for about 20 years now?
It is buried in https://www.usatoday.com/story/news/nation/2020/03/27/scient... but among the other useful tidbits is this. In California today, about 50% of new COVID-19 cases are from out of state travel. 30% are from people known to be at high risk (medical workers and family members of people who have it). And 20% from community spread. Which means that California's biggest problem now is that other states aren't taking sufficient action to reduce the spread of COVID-19.
Another common misconception is that stringent measures aren't needed in lower density areas. Take one look at Dougherty County, GA — whose outbreak was also spurred from an out-of-town traveler to a funeral:
> With a population of only 90,000, Dougherty County [Georgia] has registered 24 deaths, far more than any other county in the state, with six more possible coronavirus deaths under investigation... The region’s hospitals are overloaded with sick and dying patients, having registered nearly 600 positive cases. Last week, Gov. Brian Kemp dispatched the National Guard to help stage additional intensive care beds and relieve exhausted doctors and nurses.
IANAL, but my reading of the situation is that state governors can declare martial law. Once they do so, they have pretty broad powers that extend beyond what would usually be considered constitutional. Until that happens, I think the right to freedom of movement makes it impossible to effectively shut down interstate travel.
His comments are ignorant and frankly careless. Gates will have zero problems with a nationwide shutdown: he's the second-richest man in the world. He doesn't seem to realize that tens of millions of people will lose their jobs, businesses will collapse, crime will rise, and all sort of other unpredictable bad things will happen if the country shuts down. This isn't fixable with a paltry $1200 check that comes in a month.
"Conveniently" this virus will not affect Gates either, he can just shut himself in and ignore the world in one of his mansions for a few years.
We need to put UBI in place immediately and shut down the economy as we know it, so that our parents, grandparents, and friends don't die at horrifying rates. I know you really need to get your Whopper, but there are more important things than "the economy."
This kind of response just further proves that our "economy" only serves to enrich wealthy VCs. We can provide enough food, and housing, and other necessities that people in the country need. Where will the money come from? Where did the money for this $2T bailout come from? It can come from the same place -- just instead of funneling it to rich corporations, we should give it the American people so they can eat.
You want to argue that Bill Gates has never made a bad judgment call in his life? Are you kidding me? I know the guy called a future pandemic. I watched his TED talk. Doesn't change the fact that he's wrong on this call. I am saying with caveats: 1) leave the country open 2) require masks in public 3) temp checks for fevers 4) expand and continue drive thru testing
It's not hard to grasp that rural areas are going to have a slower rate of transmission as a matter of course because social distancing is built into those communities. For one, there's less public transportation. Two, all major gatherings have already been cancelled. Three, people are already voluntarily limiting social contact.
This disease is going to fester for another year or so. It's not practical any more to try to contain the outbreak. The idea at this point is to limit the number of cases at any given time to prevent overburdening the local community's medical resources. My mother is a nurse. They've cancelled all elective surgery in preparation for a tsunami of patients in central Florida. As a result their hospital has less than 50% utilization right now. It's slower than it normally is for their hospital! All these other health problems are getting the back burner for COVID-19. How long can you carry that on for? The disease may peak in NYC in 2 weeks but peak in Montana in 2 months. New Mexico may peak in October. You've got to have a rolling adaptable policy for each region. You cannot do blanket policies.
Where did he argue that Bill Gates has never made a bad judgment call? You still have zero evidence for your take on this, no matter how practical it may seem. You are going on your intuition and common sense on how to solve this crisis for an entire country?
Your mothers' hospital should be running tests with that other 50% of unused utility right now. Conduct trials on patients found to be positive, etc. That's literally the second point Gates made.
> It's not practical any more to try to contain the outbreak. The idea at this point is to limit the number of cases at any given time to prevent overburdening the local community's medical resources.
Lockdown is the most effective way of limiting the number of cases.
The only thing your intuition and experts agree on is the knock that the world economy is going to take. I challenge you to provide models that show that your "practical" handling of this situation won't have the same disastrous effects on the economy when instead of 3% of a smaller number of the population die, 10% of a much larger portion of the population die. These numbers are in line with countries that implemented lockdown early or have very strong government influence versus countries that implemented lockdown too late.
A lot will have to happen _during_ lockdown, you can't just sit idly by. Basically it will buy time.
Of course the virus will still spread once lockdown is lifted, but for countries like the US (not even to mention Italy and Spain) who started behind the curve any time you can buy to bolster your response should be taken.
3blue1brown's latest video on YouTube demonstrates that we can also buy time by using a combination of mitigation techniques short of a full lockdown. It's a video of a computer simulation created by a mathematician fwiw, but it shows some of our options, and that brute force may not be required.
Sometimes I want to advocate for a full global lockdown, but I think about the random emergency appendectomy, and other weird edge cases that would be complicated by a lockdown of any magnitude.
You want to argue that Bill Gates has never made a bad judgment call in his life? Are you kidding me? I know the guy called a future pandemic. I watched his TED talk.
Where did that come from? My comment is that he is not ignorant. You just agreed that he is not ignorant. In which case you shouldn't be calling his comments ignorant.
Full stop.
Doesn't change the fact that he's wrong on this call. I am saying with caveats: 1) leave the country open 2) require masks in public 3) test for fevers 4) expand and continue drive thru testing
You are convinced that he is wrong and you are right. And expect me to agree simply because you assert it.
However, as is widely reported, we do not have sufficient masks, and we do not have sufficient testing. Perhaps you shouldn't be telling everyone what should be done when you are unaware of these basic and widely reported facts.
It's not hard to grasp that rural areas are going to have a slower rate of transmission as a matter of course because social distancing is built into those communities. For one, there's less public transportation. Two, all major gatherings have already been cancelled. Three, people are already voluntarily limiting social contact
What you are saying makes sense, but I am not convinced.
In rural communities, people are spread out but have ways to get around. They often work in close proximity to each other, and whether you work in a field or paper mill, you're more likely to be working in an essential service that stays open.
Furthermore there is often a false sense of security. Major gatherings may have been officially cancelled, but the rural people that I have known are more likely to ignore such rules than city folk.
(Note, I've lived in rural areas before. I have lots of family in rural areas.)
This disease is going to fester for another year or so. It's not practical any more to try to contain the outbreak. The idea at this point is to limit the number of cases at any given time to prevent overburdening the local community's medical resources. My mother is a nurse. They've cancelled all elective surgery in preparation for a tsunami of patients in central Florida. As a result their hospital has less than 50% utilization right now. It's slower than it normally is for their hospital! All these other health problems are getting the back burner for COVID-19. How long can you carry that on for? The disease may peak in NYC in 2 weeks but peak in Montana in 2 months. New Mexico may peak in October. You've got to have a rolling adaptable policy for each region. You cannot do blanket policies.
Thinking of this disease as something that "peaks" on its own is highly misleading. It will not peak on its own without killing millions. The peaks that people are trying to project are the result of effort to reduce transmission. Nor should a peak make you too comfortable. You can ease up some, but too much and the epidemic returns.
If you put out less effort, it is longer to the peak and a more severe peak. If different areas have different policies, then you reintroduce epidemics to areas that thought they were past it. Therefore the kind of rolling policy that you are recommending is a recipe for multiple waves sweeping back and forth between regions. And for worse peaks.
Bill Gates knows this very well. It is central to his thinking. But that seems to be one of the key points about epidemics that you have not yet grasped.
Bill Gates is laser focused on the disease and pandemics, but the complex trade-offs between containing this disease and treating other health problems and the economic ramifications and the domino effects are beyond any one person's total comprehension. That's why we debate and discuss things in an open forum and we don't make Bill Gates overlord of humanity.
The fact that debate is necessary does not make all debate useful.
The prerequisite for debate to become useful is that all participants involved have to try to provide information and reasoning, and then try to incorporate new information and counter-arguments into their thinking.
Bill Gates does this. I try to do it. I look forward to your taking advantage of the opportunities in front of you to do it as well.
Again, no one is making Bill Gates overlord. But he has actual data and experience backing up his side of the debate. What exactly do you have? Where are these sources that offer insight into the economic ramifications of keeping an economy open during war or during a global pandemic?
Maybe you're right, however in Italy when they announced the shutting down of regions in the north, people fled to the south and immigrants started flying home, which helped spread the virus in all of Italy and throughout Europe.
It is now generally believed that a better strategy would have been for all of Italy to be shut down at once [1]
Also Bill Gates might be wrong on this one, but I wouldn't call his opinions in this field ignorant. Given his track record and the work that his foundation is doing, I'm pretty sure he has expert counseling and his advice on the matter is anything but.
That EU's measures differ from country to country is regrettable.
It means that countries like Germany, which are doing extensive testing (500,000 tests per week), have hospitals in good shape and overall a good administration, will get out of this crisis before other countries and will keep their borders closed for longer than necessary, this delaying everyone's economic recovery.
These days solidarity, cooperation and coordination are of the utmost importance.
Note that I am an EU citizen and I hope we'll all be alright.
As a citizen of EU member, I don't agree at all. It's good that each member can fine-tune details to their specific situation.
Italy/Spain/France are fucked and they do need super strict measures.
Meanwhile in my country we have relatively few cases. Most of them are imported and good chunk of local cases are medicine personnel. Right now we're far from full lock-down as seen in most unfortunate places. Many businesses that don't have customers on premises are operating more or less as usual. Sports outside are still allowed.
Right now amount of daily cases is not growing. Significant part of them are people coming home from more affected countries. Medical system is far from overrun. Given that the country is relatively sparse and social norms are rather distant, we're looking forward to having fewer and fewer new cases.
If all goes well, some restrictions will be lightened up in mid-April. E.g. outdoors cafes may be allowed to open up given that distance between visitors will be enforced. Next, non-essential shops may be allowed to open up for visitors with masks etc. It will probably take a long time to allow mass events though. But that's relatively small part of economy.
Why should we stay in lockdown if all is good locally, but Italy, Spain or Sweden still have ongoing crisis? We'll obviously keep our borders closed till our neighbours clean up their acts.
Solidarity is having life going on as much as safely possible and making stuff for affected allies. Not staying in lockdown side-by-side.
Because everyone else is only 20 days or so behind Italy.
As WHO experts say from their experience with Ebola and others, it's better to act early.
I see a lot of disbelief on this site too, it appears that exponential growth can fool even us.
Only 2 weeks ago I noticed people here saying that Trump must be doing something right in the US because the country hasn't gone to hell. I replied with "give it another week or two". And now the situation in New York is dire and everyone else is following, with the US poised to be the next epicenter.
What country are you from btw? Are you sure the population is properly tested? Given the lack of tests or expertise on the market I kind of doubt it.
This virus is dangerous because 75% or more of the infected population is close to asymptomatic, yet highly contagious. You might be having a lot more cases among you than you realize.
> Because everyone else is only 20 days or so behind Italy.
No. Over here we have flat growth. Amount of new cases is not growing at all. In fact last 5 days day-to-day amount was lower than record day. Meanwhile amount of tests done is growing.
> As WHO experts say from their experience with Ebola and others, it's better to act early.
Yes. And we did act early. Our situation 3 weeks ago weren't as bad as Italy or Spain, thus we didn't as harsh measures. It looks like it worked.
> I see a lot of disbelief on this site too, it appears that exponential growth can fool even us.
It's not exponential everywhere.
> What country are you from btw?
Lithuania
Best statistics we got bellow. Top-right is cases (overall vs daily), bottom-right is testing (overall vs daily).
> Are you sure the population is properly tested? Given the lack of tests or expertise on the market I kind of doubt it.
What is "properly tested"? Testing everybody? No. Testing suspects? Yes. We're also testing everybody coming from abroad (EU or not) for over a week. Before that, it was self-isolation + testing on symptoms since late february. Big chunk of new cases comes from that.
> This virus is dangerous because 75% or more of the infected population is close to asymptomatic, yet highly contagious. You might be having a lot more cases among you than you realize.
We definitely have much more asymptomatic cases. But amount of new symptomatic cases is not growing. Either it's only spreading asymptomatic (which is unlikely), or spreading is slowing down.
We're now in our 3rd week of quarantine (social distancing + restaurants and non-essential shops closed). Had it not worked, we should already see a spike of symptomatic cases.
I hope you'll be OK, however I'm not holding my breath.
I'm from Romania and we were at 500 cases and a doubling time of roughly 6 days only a week ago or so. Our cases were also imported, via emigrants returning home. Confirmed cases have exploded since then due to a couple of community hotspots and we're well on track to join the west.
So good luck to you, I hope we'll all come out of this well.
No worries, I do take this 100% seriously. I cut down my contacts to minimum, not visiting any places were people get together (groceries bought online etc), basics like washing hands etc. Unfortunately it's hard to get a mask yet, so I've to resort to scarf when coming into contact with people. And most people seem to take it seriously too.
So far we had few nasty spreads in hospitals (mostly doctors coming from skiing trips) and parties. But all cases so far seem to be +/- contained. Fingers crossed we don't get a superspreader sometime soon. Emigrants' comeback routes are virtually closed. Pretty much only traffic from outside is truckers. Easter weekend and the week after it will be make-it-or-break-it. I could see life slowly opening up if masks are widely available by that time.
Stay safe. It's not end of the world. Stay calm, wear mask, wash hands and we'll be fine.
last i heard we couldn't get a test without either paying for it yourself or proving that you've had direct contact with a confirmed corona patient... did they change that?
i just checked, it really looks like they changed it...you can now get tested if a doctor deems it necessary, which he is allowed to if you're showing corvid-19 relevant symptoms.
There's literally one state with 0 deaths, and it's the same state that had to inform our president that there aren't enough tests available for them to contain the virus. To which he responded with confusion because he was convinced that there are more than enough tests and have been for weeks (that response should tell you how much trouble we're in). It is not a matter of if, but when they will see their first death.
I'm not sure what your source of information is on this virus, but you've got an extremely naive outlook if you think anything other than a total shutdown is going to contain it at this point. And quite frankly contain isn't even the right term because we can't contain it anymore, all we can do is try to limit the death count.
Deaths on the scale of 0-10 per state are not noteworthy. Flattening the curve is about keeping the case count within hospital capacity.
We are well beyond "contain it"; it has been everywhere in US for weeks now. But low density regions with sufficient hospital capacity don't need to use the same tactics as high density urban settings where hospital beds are at a premium.
> More than 100 rural hospitals have closed in the United States since 2010 and another 430 are at risk of closing, which a new study says could have life-or-death implications for rural communities.
> University of Washington researchers examined 92 rural hospital closings in California from 1995 to 2011. They found that while the closings of urban hospitals had no impact on their surrounding communities, rural closings caused their populations — which have limited access to health care and other services — to see mortality rates rise 5.9 percent.
There is a limited amount of time we can be on a lockdown. For example, in Massachusetts where all non essential business are shut down, pretty much all routine medical care has stopped. The major safety net hospital in Boston is laying off 10% of the workforce because they are not seeing routine patients). So the time in lockdown needs to be spent wisely, otherwise we will create more health problems than we solve. 8-9 million people a year die from cardiovascular disease in the US. If that rises by just 5%, we will have made things a lot worse
Agreed. Another example: I have a dental abscess I can't get treated because all dentists have shut down at least into May. In my case it can probably wait, but some people's dental issues will lead to acute complications here and now, and also bad dental health can lead to heart problems in the long term, thus again worrying in terms of cardiovascular disease.
Doctors and dentists routinely catch colds and flus from their patients. In most countries they are not working behind a perspex face shield (and as you know, there is now a shortage of such safety equipment). Consequently, they could easily catch coronavirus during this lockdown and spread it, or even perish from it.
Cases are a really bad measure. We don't do randomly sampling in each state and we don't have any antibody tests (to see people who might be exposed, but have no longer have viral load). I found the best measures to be fatalities and the exponential scale graph by Aatish Bhatia (which uses case data, but with a lot of caveats).
> And two of the hardest-hit areas in the nation — New York City and Los Angeles County — released guidance earlier this week encouraging doctors not to test patients unless they think the test will significantly change their course of treatment. That means that potentially more people in both places could be admitted to hospitals with severe respiratory symptoms and recover — or die — and not be registered as a coronavirus case.
> Masks and fever checks along with testing should be enough to slow the spread without triggering Great Depression 2.
So right now we're at 0/3? We CAN shut the country down today, but we can't get enough masks, fever checking, and testing for everyone, and I don't know when we will be able to.
Do all the states use the same methods to count covid-19 deaths? What is that method?
In the UK we have two different numbers.
The Public Health England number is anyone who dies in an NHS hospital who has been tested (and had a positive result) for covid-19.
The Office for National Statistics number is anyone who dies where covid-19 is mentioned on the death certificate.
> fever checks along with testing
People are infectious before fever develops, and they stay infectious after their fever ends. Some people have covid-19 but don't get fever -- they might get one of the other symptoms like anosmia or upset stomach.
Masks and fever checks only do so much. First off, you need to have masks for people to be able to wear masks. That is something we don't have right now in the US. Secondly, fever checks only go so far. There are tons of people that are asymptomatic for two weeks before having a fever. Going off of China's numbers is ignorant in itself. Why don't you take a look at https://www.nytimes.com/series/people-who-have-died-of-the-c... so you get a better sense of people in just New York city dying from this?
You're missing data. The data you're missing (which you should now research) is how China blockaded cities and regions, with guarded checkpoints. Since we Americans love Freedom so much, many many more of us will die.
China didn't shut down the entire country does not give us any information on spread of the disease in China. if you are buying the Chinese figures for infections and deaths then I have a bridge to sell you.
I'm so sick and tired of this conspiracy theory going all around reddit. Do we have any reason to disbelieve China's numbers are orders of magnitudes wrong? China's numbers are wrong in the same way Italy and USA's numbers are wrong, because data collection is flawed. It is also very plausible to claim China has incentive to hide new infections in their country. Even US has incentive to have this to minimize the panic. But claiming a country with 1.3 billion people, who recently accepted WHO to audit their pandemic management has a massive epidemic when they're reporting almost no new patients is "US didn't go to the moon" level conspiracy theory. Please put your tin foil hat away.
No, it's not. Other sources of data show a massive drop in population in China correlating to the disease. There is a massive amount of evidence that China grossly under-reported case counts and deaths. I know people love to shill for China, but remember they jailed the doctor who first identified the new disease (who is now dead) and ejected all American reporters from the country after they started reporting about the massive amount of deaths being recorded as "unknown pneumonia" and not attributed to COVID-19 in Wuhan.
Studies have suggested that something like 80% of Covid-19 infections in China were not reported. In addition, recently there was credible reporting concerning the numbers of cremation urns released post-lockdown. I don't think it's reasonable to talk "tin foil hat". I do think it's reasonable to continue to seek factual answers to important questions.
no other country has reason to under report. this came from China, they downplayed the severity from the start and disappeared doctors who were reporting it. no one else is doing that. the figures may be counted differently between nations due to those with underlying conditions, but I don't distrust them like I do Chinese figures.
It's extraordinarily ignorant, which is unfortunate in the case of it being Bill Gates.
Instead, Texas and low-infection states should be helping to keep states like New York afloat through this, economically by helping the nation and in terms of manufacturing capabilities. Texas has 41 deaths and isn't seeing a surge due to its different climate.
Now you’re being ignorant. Texas rates are so low because we are not testing. I live in Austin and we are only performing 20-30 tests a day. Of course the available data doesn’t reflect the real numbers.
I would honestly ignore the case rates for the reason you stated. What if you had 500,000 tests tomorrow and discovered 30,000 people who didn't even know they had it? What does that really tell you?
Fatality rates are what people should focus on. Is Texas's fatality rates doubling every three days, or is it staying steady, or going down?
Europe is already having trouble with fruit production. Fruit is rotting because seasonal pickers can't work. If we loose food sources, a lot more people are going to die than from COVID-19.
It's crazy: All we've been hearing from politicians for months is how the virus's spread is affected by political borders. "It only spreads in China!" "It only spreads in China, Iran and Italy!" "It only spreads in China and Europe!" "It's only a problem in Washington State!" "I mean Washington and California!" "Oh, New Yorkers need to worry about it too, but nobody else!"
Turns out viruses don't care about lines on a map. Who knew?
