[crx07]

What are they supposed to do? Sometimes dealing with reality involves some pretty uncomfortable choices to make, even when that essentially makes you the bad guy.

The real issue here is that the economy was prematurely reopened before it was safe -- we have far more than enough money as a nation to have prevented this scenario from happening and chose a path of destruction out of sheer avarice instead.

[cameldrv]

The real issue IMO was that the lockdown wasn't strict enough, or enforced. Many, many stores were open, many workplaces were deemed essential, masks were not generally worn in the first phase of the lockdowns, and while indoor dining at restaurants was closed, indoor dining at your friend's house was wide open.

The three places that I know of that have gotten cases to zero are China, New Zealand, and Australia, and they all used lockdowns that were far stricter than in the U.S.

The problem is that a soft lockdown doesn't bring R low enough to eradicate the virus quickly, and people won't stomach it dragging on for months. I also don't believe that it can be done on the honor system. There must be police writing tickets or worse for violations, or there is a segment of the population that will ignore whatever measures that are enacted. Unfortunately sometimes these are even identifiable groups of people that all socialize together in violation of health orders, so the virus will spread within these communities regardless of whatever the governor puts on a piece of paper and makes a speech about.

[tsjq]

Interesting points indeed. On the other hand, India had a hard lockdown for 6-8 weeks, and yet the numbers zoomed up weeks after that. And now, the numbers are magically going down despite absolute carelessness widespread. Inexplicable

[crx07]

The numbers start going down quickly once infections have been so prolific that crowd immunity is present.

I live in Texas, but I'm sure I personally infected no fewer than 10,000-20,000 people last March, including the sorority that purportedly brought it back from Mexico during spring break. No doctor wanted to listen and no hospitals would test me even after I begged some of the best providers in the region. It wasn't until almost 9 months later that the mistake was acknowledged, and it's highly likely that community spread existed even in the US in November 2019 or even October 2019 just based on retrospective serology studies.

Places with poor hygiene controls like India have likely had far, far more infections than anyone even can imagine. That might be one of the first places to be immune.

[trhway]

>we have far more than enough money as a nation

to for example open more beds in preparation for the second wave (which was obvious to come). Instead hospitals were laying off people in the summer.

[flunhat]

I suspect the limiting factor is personnel, not beds (i.e. trained staff to manage covid patients), which can't be increased on short notice. But still -- we have incompetent state & federal leadership that basically knew what would happen yet still didn't do enough to prepare.

> Instead hospitals were laying off people in the summer.

Yup. One of the dark ironies of this whole mess has been that hospitals have been letting go of staff because they had to suspend (very profitable) elective surgeries to treat (not so profitable) covid patients. Think hip surgeries being postponed and bleeding hospitals dry as a result.

[trhway]

>can't be increased on short notice.

i think the 3-6 months that we had would have been enough to train any MD to care for a covid patient, at least for majority of cases and under supervision of existing high specialist. My understanding is that non-covid personnel had their workload significantly decreased, so they could have been trained for covid for the second wave.

[flunhat]

You might be right -- at this point, with everything that's gone wrong at the govt level, I'm pretty willing to accept rank incompetence as an explanation.

[crx07]

There are multiple points of failure. Pretending everything was A-OK is the largest one, failing to identify the virus's presence in the country for months was another, denying and downplaying the usefulness of masks was another, underfunding hospitals was another, failing to secure PPE was another, making it painfully difficult to get tested was another. There's a lot of blame to go around on this one. But reopening the economy was the biggest mistake.

[danhak]

There are many factors at play, but in L.A. I don't believe premature reopening is one of them. Bars, indoor dining and gyms have been shut down for pretty much the whole pandemic. Outdoor dining was banned (again) about a month ago.

My take is that L.A.'s issues have more to do with housing density, high number of people living with roommates and high number of multigenerational households. Also perhaps some some challenges communicating with an extremely large and diverse immigrant population.

[jchonphoenix]

I'll point you to Hong Kong, Singapore, Shanghai, and Tokyo as counterexamples. All of those cities are 3-7x denser than LA, more populous, and culturally multigenerational.

I think it's quite clear to anyone who's been paying attention at this point that behavior has more to do with containment than anything else. The US and perhaps LA in particular for some reason or another is unwilling or unable to implement the same behavioral safety measures of other countries and cultures.

Mask wearing is the obvious one. If you go to any of those 4 cities I mentioned, 100% of individuals in public are masked, whether indoors or outdoors. 6ft social distance is very strictly followed with public shaming for those that take off their masks or do not follow social distancing guidelines in public.

[stevegalla]

I suspect those 4 cities are doing more than just wearing masks. I’m having a hard time tracking down the interviews (I think it was Dr. Jim Yong Kim who said this), but there are two types of transmission between households and within households. Mask wearing, social distancing, quarantining, contact tracing, and some other measures can help to reduce between house transmission. However, you need to stop the within house transmission, too. To stop within house transmission, people are removed from their home and isolated in medical facilities in some parts of Asia.

Stopping between house and within house transmission is what I suspect those 4 cities you mentioned are doing. North America is more focused on stopping between house transmission.

Anecdotally, I know some cities in South Korea have quarantined people by placing them in an isolation room (4 people per room spread 6 feet out each wearing a mask 24/7) until they test as being COVID free. This was around 20-30 days from what I understand.

In Canada, if you quarantine, it’s 14 days in your own home. Mostly this is on the honor system. If you live in a condo / townhouse / strata or your neighbors know you’re quarantining, they can report you for violations. When quarantining, you’re restricted to a single room if you live with others, but there is still risk of passing it on to others. Anecdotally, I know of a case in Canada where an individual quarantining in their room has managed to pass COVID to 3 others who live in the house. These people were wearing masks around the house when not in their own room. If this original person was isolated in a hospital, the spread would stop at one. Since they weren’t, it ended up infecting the entire house.

[cameldrv]

This is also key. China used converted stadiums, convention centers, etc for this after a few weeks. According to them, this reduced R from about 0.8 to about 0.3. People were actually being rounded up and taken to these places forcefully.

With the number of now empty hotel rooms we have, this could easily have been provided on a voluntary/strongly encouraged basis. Instead what we got in SF for example was hotel rooms for the homeless (that hypothetically could have COVID) and no hotel rooms for people that actually tested positive for COVID.

[DanBC]

Here's a twitter thread about someone who lives in South Korea returning home from a trip abroad.

https://twitter.com/koryodynasty/status/1345210393715564544?...

People should wear masks, but there's so much more they need to do as well.

[danaliv]

At some point, “this is a free country” became “I don’t have to apply impulse control under any circumstances.”

[MattGaiser]

Indeed. LA is not that densely populated by any global standard.

[crx07]

LA is one of the most connected cities in the world. It's not LA's fault necessarily, but the country as a whole should've been on complete lockdown from April until whenever the situation was under control. Our national wealth and GDP have plenty of room for a complete quarantine, even if that means paying everyone's paychecks for a year or longer. We deliberately chose to allow 350,000+ peoples lives to end instead.

[danaliv]

I just moved to LA from New York State in December, and it seems to me that the number one problem here is noncompliance. So many people are just out and about like nothing unusual is going on. People aren’t wearing masks, or they are but not covering their nose. The number of house parties I’ve seen in the past month is shocking—and no one at these events has worn a mask. Outdoor places like beaches and trails are packed with unmasked people, which by itself isn’t necessarily a hazard, but then they aren’t maintaining a safe distance.

I’m not saying NY was perfect; not by a long shot. But here it’s like people aren’t even trying.

[Animats]

I just moved to LA from New York State in December, and it seems to me that the number one problem here is noncompliance.

Agreed. I see far too many people out without masks. It's scary.