[9uq34aofgh]

The media/political response is a giant hoax.

Read the source paper from the CDC our corporate and political leaders are using to justify the panic: https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm and appendix 5 https://stacks.cdc.gov/view/cdc/44314

From the evidence section of appendix 5:

"Mandatory quarantine delayed the peak of the pandemic, but when cost was taken into account, mandatory quarantine was not an economically effective intervention against the 2009 H1N1 pandemic"

Isolations only delay the peak, they don't prevent it, and the wreak havoc on the economy. Plus all the curve flattening talk are just poorly written computer simulations. Zero evidence it will happen.

From the paper here are the key objectives of isolation, none of which apply to covid-19 in the USA (unless hospitals are adding tens of thousands of new beds, respirators, and nurses in the next few weeks).

"Objective 1: To gain time for an initial assessment of transmissibility and clinical severity of the pandemic virus in the very early stage of its circulation in humans (closures for up to 2 weeks)

Objective 2: To slow down the spread of the pandemic virus in areas that are beginning to experience local outbreaks and thereby allow time for the local health care system to prepare additional resources for responding to increased demand for health care services (closures up to 6 weeks)

Objective 3: To allow time for pandemic vaccine production and distribution (closures up to 6 months)"

[cliffy]

Of course you're some newly created sock-puppet account too afraid to post under your real handle.

COVID-19 will absolutely cause the death of millions in the US alone if proper steps aren't taken to reduce R0. If not from the disease itself, then from hospitals being completely overloaded.

Edit: Let's be real: lockdown/isolation is going to have to persist for at least a month or more to have a real chance of preventing the spread to most of the population in the US. 2 weeks is not going to cut it.

[9uq34aofgh]

Not a sock-puppet.

Where's the evidence isolations will flatten the curve and not just cause another spike of cases after isolation ends?

Covid-19 isn't going to die out after a few weeks or months.

Deaths are coming from ages 70+ with severe pre-existing conditions during non-peak hospital conditions. This is normal and nothing to panic about.

Also, do R0 values of a virus change dramatically? I thought they were set based the number of non-vaccinated people who get infected...

[cliffy]

"R0 is not a biological constant for a pathogen as it is also affected by other factors such as environmental conditions and the behaviour of the infected population." [0]

If we hold R0 down long enough through change of behavior then we can absolutely flatten the curve.

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

[9uq34aofgh]

Thanks for the info on R0!

From wiki "What these thresholds will do is determine whether a disease will die out (if R0 < 1) or whether it may become epidemic (if R0 > 1), but they generally can not compare different diseases."

If seasonal flu (type-B?) has an R0 of ~1.3 can we reasonably call seasonal flu an epidemic?

H1N1 (spanish and swine flu) is ~1.8 and had major outbreaks in 1918 and 2009.

Is it realistic to expect we can sufficiently influence covid-19 using NPIs to achieve R0 < 1?

[Entalpi]

"Isolations only delay the peak, they don't prevent it, /.../ Zero evidence it will happen."

Isolations and shutdowns limit virus transfers. This is 'flattening the peak'. The peak will always be there and since the only way not to have a 'peak' is to not have virus to deal with from the start!

[9uq34aofgh]

I agree a temporary reprieve of infections from isolation will happen and based on the type of pandemic isolations can be an appropriate response.

What I haven't found is good evidence of what happens after isolation ends? Why won't a peak happen soon after? Any scientific sources you can point me to?

Also, the economic affect of isolations must be taken into account when implementing NPIs. The paper from the CDC states the economic disaster of isolations outweighs its general usefulness. This seems especially poignant for covid-19.

[toast0]

What happens after isolation ends will depend on a bunch of things.

If testing capacity and health department capacity is available to do contact tracing on new cases, we would see (significantly) reduced spread as unknown carriers could be tracked down.

If the virus has reduced viability in warm weather (as has been suggested) and isolation ends during warmer weather, that will reduce the rate of new infections vs today without isolation.

If many people with undiagnosed cases heal during isolation, they may not transmit to anyone, and they may emerge with some immunity afterwards, reducing spread when isolation ends.

There's certainly a chance none of this works well. There's also a real chance that the (mostly longer term) negative health effects from isolation outweighs the (mostly shorter term) negative health effects from an uncontrolled epidemic.

I think it's pretty unlikely that the peak after isolation will be as high as the peak without isolation, and there's hope that with isolation, the health system won't be overwhelmed with this to the exclusion of other urgent needs. The economy is going to be a big mess with either isolation or an uncontrolled epidemic.

[JoeAltmaier]

I'm confused - what economic effect outweighs "1,000,000 dead"?

[9uq34aofgh]

Your assumption seems we should spend an infinite amount of money keeping everyone alive. While admirable that is not the world we live in. Every day doctors, corporations, and politicians make decisions weighing how much to spend to keep individuals alive.

Your healthcare plan has a max spend. Your life insurance has a max payout. Our police force has a max enforcement capacity for keeping people safe. Etc, etc.

So given we have never been willing to spend infinity to keep everyone alive. What is a reasonable compromise for a given risk scenario?

Covid-19 is 99.9999% survivable for those under 70 with no pre-existing conditions. Should we tank the economy by trillions of dollars for months or years? Should we negatively affect 300 million Americans - their jobs, education, housing, etc - instead of calmly reviewing alternative measures to mass isolation?

The real question is how do we keep the roughly 49 million Americans over 70 safe. Instead of destroying our economy, why not spend millions of dollars to provide programs to help them stay safe. Far more reasonable and inline with the specific threat of covid-19.

Mass isolation feels like using global variables. It's quick and looks reasonable to newbies, but in the end creates worse problems than it solves.

If you have scientific evidence supporting mass isolation for a pandemic like covid-19 please share.

[DanBC]

> Covid-19 is 99.9999% survivable for those under 70 with no pre-existing conditions.

No, your six 9s are wrong. So far, the best quality evidence we have says: https://twitter.com/ShaunLintern/status/1239693272311828483/...

If you are aged

   10-19 you have a 0.006% chance of death
   20-29 0.03%
   30-39 0.08%
   40-49 0.15%
   50-59 0.60%
   60-69 2.20%

> If you have scientific evidence supporting mass isolation for a pandemic like covid-19 please share.

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

[9uq34aofgh]

I appreciate the correction from 99.9% to 97% survival rate for those under 70.

Thank you for sharing the link to the imperial college article. Here are some of my key take aways:

- 100,000's of people will still die even under ideal isolation conditions (didn't see an exact #).

- Isolation must happen until a vaccine is available (likely 12-18+ months).

- If isolation ends before a vaccine is found infections will quickly spike thus only delaying the dreaded hospital overflow.

- Best reasonable NPIs appear to be isolating 70+ and having sick people stay at home.

- The authors state there are many uncertainties in NPI policy effectiveness.

As with any complex topic, nuance and detail is important. The American populace is accepting of mass isolation for a few weeks, but what about months or years?

Do we really want to be isolated for the next 18+ months? Are we comfortable with families losing their jobs, home, and more? Are we comfortable with the elderly losing a big chunk of their retirement investments which may not rebound before they need it?

Again, if we don't mass isolate until a vaccine is discovered, then all we're doing is wasting time and money with mass isolations.

There are lots of diseases in this world that kill people and we can't control them all. This is a normal and sad part of the circle of life. We must evaluate reasonable measures, with clear and honest public discussions (a stretch, I know).

I understand my perspective against mass isolations isn't popular, but I'm not seeing much evidence to refute it.

[Entalpi]

Welcome to philosophy. Here we can argue about what life is and how the utter meaningless life would without icecream.

Now, welcome back to reality. A overloaded health system will kill people. Doctors will need to triage. People with no relation to COVID-19 will die who would otherwise make it. Because of overloaded health systems.