[pmiller2]

No, it doesn't mean "stop sheltering in place," unless cases of COVID-19 have peaked. In order to tell whether they've peaked, you need testing in place, as well. Even if they have peaked, it could mean "relax some of the restrictions, but not fully end SIP, while monitoring cases." Opening things back up prematurely, without sufficient testing, is just going to get people killed.

[manigandham]

Why do cases matter? It should be the death rate that peaks, and that's measurable without testing. In fact it seems to be over-attributed since many deaths are now being classified to Covid even if there are many other factors.

[pmiller2]

Death rate is the proxy for cases. What matters when attempting to contain the disease is prevalence of the disease.

[jfnixon]

I think this is backwards. We have been using infection rates as a proxy for death rates, since deaths are a lagging indicator. It is certain we are missing a huge percentage of cases, and expanding testing will uncover those. It is completely unclear that uncovering more mild and asymptomatic cases will result in more deaths, so new cases are a bad proxy for future deaths.

[pmiller2]

Maybe in an ideal world, but we're not actually measuring infection rates. Dead is pretty objective, and easy to measure, and, we know that the number of deaths will roughly track the number of infections. That's why things like deaths and hospitalizations are what the state of California is watching closely.

[manigandham]

Is that the actual goal? Seems like we're well past containment now with infections in the millions. But if death rates are staying low and healthcare has enough capacity, then what does widespread testing accomplish?

Might as well save it for the people who actually get sick and need confirmation for treatment or cause of death.

[tdeck]

> it seems to be over-attributed since many deaths are now being classified to Covid even if there are many other factors.

Citation?

[sfj]

> Opening things back up prematurely, without sufficient testing, is just going to get people killed.

But how many will get killed? Allowing people to drive down the street also kills people. What's the limit?

[pmiller2]

Well, do you have research on how many excess deaths there would be if states started opening up now? California is taking a cautious approach by only opening in stages after cases have stabilized, and only after testing is present. Do you have a better plan than what a group of public health experts have come up with?

[umvi]

> Do you have a better plan than what a group of public health experts have come up with?

As far as I can tell, public health experts (and basically all medical experts) are in over their heads on this one. It's like 1970s computer scientists issuing guidance on a stuxnet-esque infection. Sure, they are the experts in that they know more about computer science than other people, but they also have no experience with something like stuxnet-esque worms and so... how valuable is their expertise? "We recommend turning off all computers until further notice to stop the spread of stuxnet. Meanwhile, we will take 6-12 months or more to try and reverse engineer it and then we will issue further guidance." Except... "turn off your computer for a year" isn't going to fly with the general population. After so many months there will be riots and people will start disobeying.

[pmiller2]

And, what knowledge and/or credentials do you have to base the conclusion that "public health experts (and basically all medical experts) are in over their heads" on? Do you know what contained the outbreak in China, South Korea, and other countries?

[umvi]

> And, what knowledge and/or credentials do you have to base the conclusion that "public health experts (and basically all medical experts) are in over their heads" on?

Nobody alive on earth right now has ever experienced anything like this before at this scale. So by definition, there are no "veterans", there is no one with any experience whatsoever, just people who did case studies of past pandemics when air travel didn't exist and people that ran some simulations. Inexperienced people, no matter how expert they are, are terrible at predicting the future (re: the last 20 years of climate change expertise). "Oops, the model was wrong again, but we learned more for next time!"

> Do you know what contained the outbreak in China

How do we know it's contained? China kicked out all western journalists and nobody can audit any of their numbers. China is not exactly a clean/sanitary place, I wouldn't put it past CCP to simply cover it up to save face. Or maybe they realized it's not really as bad as it seems and they just let it run rampant.

How is Japan faring so well despite not sheltering in place and not testing?

[pmiller2]

Japan? Not well:

> There are just five ICU beds per 100,000 people in Japan, less than half the number in Italy, and doctors' associations have warned that hospitals are already stretched thin. [0]

I notice you skipped South Korea. What stopped it there?

Glad you are admitting your own ignorance. Now, if you would just listen to the people who do know a little something about viral epidemics and their containment, you could cure that little condition.

In the meantime, you should stop spewing these dangerous ideas. You sound exactly like the Texas Lt. Governor. And, let me tell you: neither I nor my family are dying for you.

---

[0]: https://www.cbsnews.com/news/japan-state-of-emergency-extend...

[jfnixon]

Bingo for the Japan observation.

[kalleboo]

> Do you have a better plan than what a group of public health experts have come up with?

Sweden's response is also based on public health experts. And in Sweden, the apolitical public health agency is fully in charge, politicians meddling with their work is against the Swedish constitution. And the Swedish public health agency has stated that their response takes into account comprehensive long-term public health and not just short-term.

Is Sweden's response wrong? Maybe. But do you have a better plan than what a group of public health experts have come up with?

[sfj]

I think that, instead of requiring locking everyone in their homes to save a few, we should give people the option to isolate themselves from everyone else. This would entail free rent and clean food delivery sponsored by the government.

This would then reduce covid-19 to a risk factor on par with every other self-inflicted risk. If you worry about your health, stay home, if not go live your life. It would actually be compatible with our constitution as well, which would be nice.

[AstralStorm]

One thing I'm not seeing happening is surveys and epidemiology related to impact of various measures undertaken, to keep the ones most effective and lose the others that are superfluous.

This could be done by comparing measures taken in a big random sample of confirmed cases with big random sample of general population.

[umvi]

> Opening things back up prematurely, without sufficient testing, is just going to get people killed.

Yep, some people will die. That's unavoidable. Tens of millions die every year. Hundreds of millions will die per year in a few decades. That's life.

If you are at-risk, you should continue to avoid contact with others. But there's currently no cure for covid-19 other than your own immune system. The sooner the disease runs its course, the sooner we can return to normal. Sheltering in place forever means you prolong the propagation of the disease to excruciatingly long timescales.

[pmiller2]

No, it's entirely avoidable. I'm referring to unnecessary deaths from COVID-19, which, as we've seen here in California, and the Bay Area specifically, have not hit numbers suggested by initial models because we implemented shelter in place.

I don't see anything more to your argument than what the woman standing with a sign saying "I want a haircut" is saying. Your attitude is dangerous. People will die unnecessarily if state leaders do as you suggest. This is what the modeling says, and you have offered nothing to suggest otherwise.

[postalrat]

Are you willing at all to consider the models were flawed and shelter in place is only delaying deaths a few months?

[pmiller2]

Not until you can demonstrate that to me.

[6nf]

Lets wait a few months and see

[_y5hn]

Are you willing to educate yourself about R?

[fzeroracer]

Bold of you to assume that a disease can just run its course and then end. Would you say the same thing about the Chickenpox or some of the earlier flu pandemics we've seen? Are you willing to bet on a far deadlier second wave not occurring?

[umvi]

> Bold of you to assume that a disease can just run its course and then end.

Not that bold, since it is how most diseases/viruses work (with a few exceptions like HIV, and there's no reason to assume covid-19 is an exception)

> Would you say the same thing about the Chickenpox

Yes, chickenpox is one-and-done. Once you've had it, you (basically) can't get it again.

> Are you willing to bet on a far deadlier second wave not occurring?

Yes - "Survival of the fittest"

If there is a second wave, it will only affect survivors of the first wave, and as far as I can tell, the vast majority of first-wave survivors had mild-to-no symptoms. Kids are barely affected at all, it seems.

[pmiller2]

> Yes - "Survival of the fittest"

Are you suggesting that people who have the ability to isolate themselves at home while still earning a living are somehow "fitter"? As I suggested before, your argument as a whole amounts to nothing more than the woman who waves the sign saying "I want a haircut". Is your life more important than your barber or stylist's? If not, why are you asking them to risk it for you?

[umvi]

No, I'm suggesting those that are most vulnerable to covid-19 (old, immuno-compromised, etc) will die off in the first wave and won't be around if there is a second wave. You can't die twice. Thus the mortality rate would plummet.

[pmiller2]

And, that's exactly why we're sheltering in place.

Which do you value more: those peoples' lives, or corporate profits?

[fzeroracer]

Okay, I guess I have to explain some things here.

> Not that bold, since it is how most diseases/viruses work (with a few exceptions like HIV, and there's no reason to assume covid-19 is an exception)

This is objectively wrong and I'll lead into why in the next point.

> Yes, chickenpox is one-and-done. Once you've had it, you (basically) can't get it again.

Chickenpox is not one-and-done. If you catch chickenpox, the virus remains latent and can manifest itself as Shingles.

And to explain a bit of history here: I'm not talking about a second wave of the current strain. I'm talking about a deadlier strain. That was what my reference was to earlier flu pandemics and I highly suggest you do a bit of reading on that. The Spanish flu had mutated to a far deadlier version during the second wave and spread all over the world.

For all the comparisons people make with the flu virus, people seem to ignore that viruses can come and go in waves. The flu did not 'end', it mutates every season and the reason why we're able to keep it under control is because of widespread vaccination preventing it from growing exponentially. You claim that's how most diseases work, but that's not how the flu works. The danger of letting the coronavirus run rampant is severely understated by our complete inability to control it right now.

[umvi]

> Chickenpox is not one-and-done. If you catch chickenpox, the virus remains latent and can manifest itself as Shingles.

The boils covering your entire body is one and done. Shingles is far less severe by comparison (my sister had it in high school and it was just a painful rash on her side that went away after a few weeks- and yes, it was definitely confirmed to be zoster despite her young age) and only reactivates in a small percentage of people who had chickenpox. Shingles kills basically no one compared to chickenpox.

> The danger of letting the coronavirus run rampant is severely understated by our complete inability to control it right now.

There's tons of evidence suggesting the mortality rate is way over-estimated right now and the amount of total cases is way higher than the number of confirmed cases due to people getting it and showing very few, if no, symptoms. This is nothing like the black plague. Hardly anyone is dying, even in places without shelter in place.

[pmiller2]

I believe you are conflating the case fatality rate with the infection fatality rate.

> Kilpatrick, from UC Santa Cruz, said that if the estimates from New York stand up to scrutiny, the infection fatality rate in New York City would be approximately 0.8%.

> [...]

> Epidemiologists at the London School of Hygiene and Tropical Medicine, for example, analyzed data from the Diamond Princess, the ill-fated ship on which more than 700 passengers got infected. Researchers adjusted for the fact that cruise passengers are older than average and estimated the coronavirus’ infection fatality ratio as 0.6%.

[...]

> Now let’s talk about the flu. Comparisons to the flu keep coming back like a many-headed hydra, and they roared back last week with a vengeance.

> The estimates I’ve seen for influenza IFR range from about 0.14% on the upper end to 0.04% on the lower end. So if the IFR for this coronavirus ends up being around 0.5%, that’s still many times worse than the flu.

[...]

> Marc Lipsitch, head of the Harvard T.H. Chan School of Public Health’s Center for Communicable Disease Dynamics, has estimated that ultimately 20% to 60% of the population could be infected with COVID-19. By comparison, because of immunity provided by flu shots and past infections, only about 10% to 20% of the population gets sick with influenza every year, according to Kilpatrick.

> Kilpatrick sketched out what this meant: “If it’s five times deadlier than the seasonal flu, and three times as many people are going to get it, that means we’re going to get 15 times as many deaths. And 15 times 30,000, which is the middle-of-the-road kind of a seasonal flu year, that’s 450,000 deaths — about half a million deaths — that’s a pretty big, scary number, I think.”

All quoted text is from https://www.propublica.org/article/what-antibody-studies-can...

Is 450,000 people "hardly anyone"? More importantly, what matters more to you: their lives, or corporate profits?