[groby_b]

"The only method that works is quarantine"

Literally nobody in the epi community believes that. Would you please state your credentials, or cite a credible source for that statement? (For the opposite, please do read takes from Trevor Bedford, Mark Lipsitch, Carl Bergstrom, Andy Slavitt or really pretty much anybody in the field)

We (the US) are currently in a state were suppression is the only prudent tool. As SK has shown, contact tracing & testing help a lot once you're not completely inundated by cases (and actually have a meaningful supply of equipment)

Yes, there are privacy concerns. Work on them. Address them. But blanket statements like "only quarantine works" are extremely detrimental to public health efforts - the last thing you want is an "all or nothing" mindset

[bosie]

> We (the US) are currently in a state were suppression is the only prudent tool

How do you know that this is the current state?

> As SK has shown, contact tracing & testing help a lot once you're not completely inundated by cases (and actually have a meaningful supply of equipment)

"meaningful supply of equipment" means this option is not possible in the US?

[TeMPOraL]

> How do you know that this is the current state?

Look at the number of cases and their regional distribution, realize that those are tested cases and thus, with a) asymptomatic carriers and b) really bad testing in the US, the number of active cases is at least 10x that. Then realize you're dealing with an exponential process. United States are thoroughly infected already.

> "meaningful supply of equipment" means this option is not possible in the US?

Not now, but if and when the US implements proper suppression measures, and the number of cases goes down to manageable levels (while at the same time the supply chain of PPE catches up to demand), then the supply of equipment will be meaningful.

[bosie]

I guess i misunderstood surpression. Thought surpression is the early stages and not when you have been thouroughly infected already.

"meaningful supply" was in the context of avoiding a lockdown and hence i don't undrestand your answer. if you don't have the equipment now, how do you avoid the lockdown and make the levels go down without large quantities of dead people?

[groby_b]

I'm not an epidemiologist, or an MD, so with a large grain of salt:

Containment: Testing & contact tracing - you try to contain the disease before it widely spreads. Usually one of the early stages of fighting.

Mitigation: You can't contain any more, and you're trying to slow down the progress to avoid a large peak. Test & treat those with severe symptoms, encourage people with mild symptoms to stay home, encourage people to keep distance.

Suppression: Things have hit the fan. You need to drastically halt the progress of the epidemic. This is shelter-in-place, lockdown, quarantine etc. #staythefuckhome has become a bit more mandatory. That's pretty much where we are right now. You want to drastically reduce the number of infections in a short amount of time.

"Meaningful supply" was in the context of suppression actually taking hold. At some point, you're hopefully down to illness levels where containment or mitigation make sense again. But for that to happen, you need tests, you need PPE, you need infrastructure so you actually can contain. We're at suppression/lockdown because we failed at that the first time round.

So, it's not about avoiding the lockdown now.

The goal is lockdown now to prevent catastrophic overload and buy time to get supplies in place for later containment stages.

Hope that clarifies? But, of course, containment is not guaranteed to work, so we might be cycling back and forth between those measures

The report #9 from the Imperial College of London details the ideas behind that cycling approach: https://www.imperial.ac.uk/media/imperial-college/medicine/s...

[bosie]

Great, thank you very much for the thourough reply and link.