Mass Testing to Fix the Labor Market

What is the scenario for going back to work? Testing and tracing. In fact, two types of tests. First, the test for COVID-19 which says if an individual is infected. After deadly delays caused by the FDA and CDC we unleashed the private labs and the states and are now ramping up the number of tests. As of today, we have run about 80 thousand but we need many more and with every positive test we need to isolate and contact trace. Test, isolate, and trace. Health care workers need daily testing. We don’t need to test everyone but we do need to test enough to get the number of new cases down to a level that people feel comfortable returning to work, to shop, to eat. In China yesterday there were no new local infections. We can get there.

The second test is for COVID-19 antibodies which indicate that the person was infected and recovered and may thus have some immunity. An antibody test was just announced. The test looks only at one antibody and this doesn’t guarantee immunity. Nevertheless, people who have been infected and recovered are valuable. The blood of recovered individuals may be useful as a treatment. (N.B. The NIH Vaccine Research Center is looking for otherwise healthy recovered COVID-19 patients who are willing to donate their blood for study. Please contact.) In addition, recovered individuals have a kind of superpower and would be highly desirable workers. Recovered individuals are better able to help the sick at lower risk, for example (David Balan made this point in an unpublished piece). Moreover, a non-infected person would be very willing to work with a recovered person so the effect on labor supply is amplified.

As with the financial crisis, there are some bad risks out there but no one knows where and so every borrower/worker is suspect and no one is lending/working. With more information we can separate out the bad risks and get the majority of people working again.

To be clear, things are going to get worse but there is a reasonable scenario for recovery. Social distancing, including all the shutdowns, will start to show an effect in a week or two. With luck and effort we may stop SFO, Seattle and NYC from going critical and we can then start to bend the curve nationally. If we greatly expand testing, it’s possible that we can get people back to work in one or two months. That will not end the crisis–a fall rebound is possible and we can expect outbreaks. But if we test quickly and widely at the first sign of an outbreak, outbreaks can be contained. A vaccine is also possible and perhaps faster than most people think. Treatments will also improve. Testing and tracing buys us time.

We can get the economy back on track. Testing, isolating and tracing will do it much faster and cheaper than dealing with a prolonged recession.

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I don't understand why anyone thinks we have "one or two months" to spare. If they lock us down, like they are starting to do, what do they imagine poor people will do? Stay home and watch their bank accounts go negative? What does anyone expect to happen to grocery store shelves? What will I do when I need to refill my insulin prescription, but the pharmacy is closed "because lockdown?"

Flattening the COVID curve is only a good idea insofar as it doesn't spike the curve for all-cause mortality.

Nobody is proposing to close grocery stores, pharmacies or businesses involved in drug and food production and distribution.

Like plexiglas manufacturers. https://www.theglobeandmail.com/business/article-sobeys-to-install-plexiglass-barriers-at-checkouts-as-grocers-work-to/

Think that one through. Who do you close? A recent event I've been involved in told me one thing; regulators and politicians haven't the faintest clue how the economy works and who does what.

Certainly, keeping such a large number of business closed is not sustainable over time. No one said differently. There will be trial and error and some risk taking. I don't know how fertilizer is made but we'd better make sure it continues being made. Same for all of the spare parts for vehicles, heavy machinery, industrial freezers, container ships, medical equipment, etc. Given the now-famous shift of American employment toward services and the fact that Chinese production is starting to come back on line, we should be ok, even if state governments make some mistakes along the way.

An issue came up in the last couple days about farm workers needed to pick crops. Everything about how that is done raises flags, and the easiest thing to do is to say stop.

If any government with a sizeable agricultural segment doesn't have people, smart people on this right now, they should be drawn and quartered and replaced before it gets worse.

There is this weird notion that I've heard from many people, including those who should know better, that the economy isn't important, health is. No no no. The economy generates products that keep us alive. Even restaurants, seemingly a luxury. What percentage of the population do they feed? How are those people going to be fed if they are closed? The question should not be whether to close them or not, but how can they be structured to feed people safely?

The economy cannot be shut down for a couple months without doing extraordinary harm, as unpredictable and dangerous as the virus.

Amen.

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+1

Many are underestimating how interconnected the economy is. We can shutdown certain activities (many services) and we can pause some manufacturing for a short period of time. But we're going to run into critical shortages of key components quickly if the shelter in places mandates extend to widely or over too long a time frame. Good luck trying to define essential components in any coherent way.

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"There is this weird notion that I've heard from many people, including those who should know better, that the economy isn't important, health is. "

+1, though to be fair, most of those comments are from idiots, I usually the people that should know better make more nuanced statements

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I have a small manufacturing business and fit in some of the categories you mention. Based on what I've seen in the past couple of days from suppliers and customers, it is about to get very bad. Politicians, policy wonks and academics have no idea how this stuff works. Material needs to be flowing through these organizations and labor needs to be available. Otherwise it all falls apart. I am operating because I have some government contracts directly linked to national security. But I've lost some customers and some suppliers which is very soon going to mean that I can't operate either. And employees throughout this chain will be losing paychecks. This is most of America.

I see the other side of this. My wife is in the information side of the economy. Her company is all working from home. Great. They were even offered a "mental health day" this week. Great. They are somewhat productive. For now. This will not last. 2-3 weeks and this all falls apart.

Yes. People don't understand that the goods economy can't be shut down (or at least most of it can't). We need those o-rings.

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I totally agree Derek. The economy is vitally important. The shutdown will cause a lot of pain and misery down the road.

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Read I, Pencil, would you please?

It would be easier to come up with the list of non-essential industries.

+1

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There's no such thing as a non-essential industry.

Restaurants. No *need* to go out and eat unless you are a traveler.

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I'm surprised we haven't seen any of the obvious blockchain-based solutions proposed to solve this crisis.

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I'm in the "possibly infected and recovered" group. Mild fever. Chest tightness for a week. That passed yesterday. Occasional coughs now.

I have self-isolated at home for 10 days. Right now, I can't be sure I actually had coronavirus. Don't know whether I am immune.

So here I stay until a test for antibodies arrives...

(for context, I'm in central London. Very international environment. Work colleagues had mid-term breaks in Italy, France, Spain etc. I passed through Madrid airport 3 weeks ago. Many of us had recent fevers/chest tightness. All under 50; no ongoing complications)

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Well said Alex, you have partially restored my faith in your profession. Trace is the next big challenge and it is mundane work done with phone calls. Americans are not emphasizing that part of the current spike is an expected travel related echo. It is Community transmission that has to be the focus. Self-isolation works.

Add masks to your list Alex. In Asia, they’re wearing masks. Here I don’t see many people doing that. It does help contain the virus.

I think the CDC is still blathering on about masks don't help healthy people, which is obviously a lie, since they certainly do help healthy medical staff, EMT's, police, etc.

The issue is more that they don't have much of a marginal benefit to most laymen. Yes, N95 masks protect you if you combine them with rigorous hygiene habits. But, most people won't practice these hygiene habits and, in the meantime, the finite supply of N95 masks is needed by front-liners.

Also, medical staff, EMTs and police, by the very nature of their jobs, are natural super-spreaders and cannot practically engage in "social distancing" so it is vital to provide extra protection to them. If a critical mass of medical personnel become infected and can no longer work while, in the meantime, the virus continues to spread exponentially, that is quite possibly an apocalyptic scenario.

I can see an argument of N95 vs a surgical mask, but they aren't making that nuanced of an argument. They are saying, there's no need for the public to wear masks. That's not supported by the facts.

"Also, medical staff, EMTs and police, by the very nature of their jobs, are natural super-spreaders and cannot practically engage in "social distancing""

What about waiters? How about day care providers? Teachers? Toll booth workers?

Masks are really cheap, and they help reinforce the critical habit of not touching your face.

Furthermore, South Korea certainly believes they are critical:

https://abcnews.go.com/International/south-korea-takes-measures-face-masks-domestically-amid/story?id=69254114

Who advice are you going to take with respect to the coronavirus at this point, the CDC or the SK Medical establishment?

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Here are some links suggesting that it might be a good idea for everyone to wear a mask when they are out in public.

The first link is an interview with George Gao, the director-general of the Chinese Center for Disease Control and Prevention.

When Gao was asked "What mistakes are other countries making?," he answered, "The big mistake in the U.S. and Europe, in my opinion, is that people aren’t wearing masks. This virus is transmitted by droplets and close contact. Droplets play a very important role—you’ve got to wear a mask, because when you speak, there are always droplets coming out of your mouth. Many people have asymptomatic or presymptomatic infections. If they are wearing face masks, it can prevent droplets that carry the virus from escaping and infecting others."

Not wearing masks to protect against coronavirus is a ‘big mistake,’ top Chinese scientist says
https://www.sciencemag.org/news/2020/03/not-wearing-masks-protect-against-coronavirus-big-mistake-top-chinese-scientist-says#

Would everyone wearing face masks help us slow the pandemic?
https://www.sciencemag.org/news/2020/03/would-everyone-wearing-face-masks-help-us-slow-pandemic#

More Americans Should Probably Wear Masks for Protection
https://www.nytimes.com/2020/03/27/health/us-coronavirus-face-masks.html

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What a nightmare. Thinking of Anne Frank huddling in an attic against a knock on the door that takes her family away for death. How did they survive the concentration camps? Did they feel the way I feel?

I am terrified for the first time in my life. Wondering if this is how the world ends - Not with a bang but with a cough.

Don't know what the truth is and the world seems confused. What are my odds? Who will be here at the end of the year? I was having a good life and a virus marches across the border and my life changes almost overnight. Who will survive this? I knew I should have exercised and watched my diet better.

I made a few calls to people I had let drift out of my life. It just made me sadder. I have a minor child and asked who can take her in if something happens. My mother was an orphan at 12 and it affected her in many ways her whole life.

Will this be worse than the Spanish Flu? An oddity from a distant time. Smallpox. The plague. Read about them. Thought that was rough but never internalized the nightmare for parents and loved ones.

Will I survive? What are my odds? How will I go into that night?

In all likelihood, you will be fine.

Are you a doctor, epidemiologist, or astrologer?

I'm a doctor, technically.

But I don't want to use an authority argument. From his post, DanC has a minor child. He is probably not too old, say less than 60. At this age, serious complications are rare and the mortality rate is certainly well below 0.5%. In other words, even if DanC catches the virus (I wish him not to), "in all likelihood, he will be fine"

+1, according to the current medical information Covid19 has a lower mortality rate as the flu if you are under 20, about the same if you are between 20 to 40, 0.5% for 40-50, 1% for 50-60. From there it climbs rapidly.

Most people will be fine, though obviously we can lower the overall death toll by taking preventative measures. It shouldn't be a dramatic concern to life for anyone under 60.

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Joel and JWatts,

"Based on the discussion of the definition of the case fatality rate (CFR), we should stress again that there is no single figure of CFR for any particular disease. The CFR varies by location, and is typically changing over time.

However, with a good understanding of the measure and its limitations, CFR is helpful for understanding what we currently know about the severity of the disease and for responding accordingly.

In the period up to and including 15th March 2020, the global Case Fatality Rate for COVID-19 are as follows.

Case fatality rate globally = 3.7%
[based on 153,523 confirmed cases and 5736 deaths]

Case fatality rate in China: 3.9%
[based on 81,038 confirmed cases and 3204 deaths]

Case fatality rate for the rest of the world: 3.5%
[based on 72,475 confirmed and 2532 deaths]

As explained above, this number has changed and it will continue to change. It’s currently higher than the estimates of a CFR of around 2% that were published until early February."

This is Oxford University's World in Data Site which has collected the data from around the world and does an excellent job explaining it.

here is the link: https://ourworldindata.org/coronavirus

But the denominator of the CFR is the number of confirmed, including tested positive, cases, yes? So the CFR is an overstatement of "IFR" -- infections fatality rate.

It's clear in the report.

Everyone should read the documents for themselves. Not rely on anonymous web commenters. Go to a website that has in the pool of commenters doctors and epidemiologists to get your information or see how others critique them.

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Johns Hopkins also has a site that is devoted to this subject as well. This site contains data from doctors and epidemiologist who review it before publication, and not anonymous bloggers who do not disclose their background or expertise.

Here is the link: https://coronavirus.jhu.edu

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Bill, for a lawyer, your reading comprehension is lousy.

I clearly stated the Mortality rates by age, and you replied by restating the mortality rate as an aggregate.

For that matter, the information is on the same page to which you linked. It's clearly shown in the graph labeled: [Coronavirus: early stage case fatality rates by age-group in China]

Coronavirus is really deadly to elderly people, it's about as bad as the flu for younger people and somewhat worse for the middle aged.

I don't read comments that call people names or rely on ad hominem.

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JW, Evidently you didn't go to the page you claim you did as I linked to the report. I can't copy all the material for you, but suggest you go back and look at the categories by country.

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If you have trouble reading the Oxford World of Data material,

Here is a video that explains it all: https://youtu.be/Hks6Nq7g6P4

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Regretfully I am over 60 and diabetic. I had my daughter later in life.

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The odds for the average person are good, not great. The bigger concerns are:

1. Losing family members and friends who may be more vulnerable
2. Having some other emergency medical condition and not getting treatment because all of the hospitals are overwhelmed
3. Or getting treated but then getting infected when your immune system is already compromised

Stay healthy and look out for friends, family members and neighbors less fortunate than you and, yes, things are more likely to be ok than not.

My brother, Deimos, and I are having a great time!

And, in six months, Cuomo (NY), Newsom (CA) and Trump will be thumping their chests about to how they saved America from COVID 19.

Nonessential CA and NY are closed. Markets are off 30%. Airlines, electricians, hotels, markets, plumbers, restaurant, etc. workers out of business/work. What is that 25% unemployment?

Hugely unlikely (as in 0.1% chance for the general population) COVID19 will kill you. Hugely likely the crazed overreaction to COVID 19 will get you.

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"The odds for the average person are good, not great."

A 35 year old has a 99.8% survival rate according to the best data we have.

I will point out the caveat that smoking, sex and health conditions matter. A healthy, non-smoking, female may well have a 99.99% chance of surviving, whereas a male smoker might only have a 99.6% chance of surviving.

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Sorry, but you do not know that your idea works in China. You know what the Chinese government asserts to be true. This would be the same government that lied to cover up the problem in the first place, as well as punishing doctors and scientists who tried to deal with it. It has lied about and continues to lie about the Great Leap Forward, the Cultural Revolution, the Tiananmen Square massacre, its enslavement and murders of Uyghur Muslims, and the list goes on. And it kicks out scholars and reporters who don't curry favor with the regime. So, seriously, are you taking the Chinese government's propoganda at face value?

All true. And I don't much trust the US fedgov either.

Though having an oaf as President with a tendency to blurt out truths as he sees them is probably an improvement over the previous three.

But the “ truths as he sees them“ are usually all not true.

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Like the truth he blurted that he saw the pandemic very early but maintained it was all good 2 days before ? There must have been at least a tiny element of untruth that you can find in this episode. A needle of lie in a haystack of truths as he sees them. A glimmer of a lie ?

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I don't trust any of the China data, but we do have the South Korea data, and they have been highly successful following that strategy.

I talked to a friend from South Korea. They are amazingly disciplined about social isolation. Limiting one worker to an office at a time. Use masks a lot.

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Reality impinges.
https://twitter.com/annieeenyc/status/1240823169532989440

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We can't know what the result of all this will be in its entirety but somethings are already apparent. Since paper money can be a carrier of the Wuhan flu and other viruses and bacteria there will be a major push to digitalize the monetary system, something the nation/state has had on its mind for some time. US state governments influence in the federal system has been in decline for years. The draconian proclamations by various state governors have given new life to these insignificant figures and they will be reluctant to give it up. A national/state tug-of-war for power is likely, the states will lose. Travel restrictions will become more and more onerous, based ostensibly on health concerns. The TSA will attempt to take over a health monitoring role, as well as security, in travel and that bureaucracy will expand dramatically to meet it. Large gatherings of people will be closely scrutinized and may not be allowed if certain conditions aren't met. Individuals with proven immunity, by means approved by the government, will be licensed to travel or work in capacities that will be denied to others. It's going to be a new and different society.

How many puts did you buy Chuck?

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"every positive test we need to isolate and contact trace."

We aren't doing this. One friend with the virus in Texas hasn't been asked for his contacts after six days of testing positive, and hasn't been given guidance on what to expect or when to go out again.

We aren't even testing people. Another friend in New York thought he might have been exposed, then came down with a fever and aches. He was told he doesn't qualify for a test because of lack of international travel and symptoms not severe enough. He's been self-isolating on his own judgment, but was told by a doctor that he could go to a clinic, and that he 'might' receive a test if he wants one. He's decided it would be a bad idea to possibly infect people along the way...

Even as we turn off the economy and work on trillion dollar bailouts, we still aren't taking the basic steps that have appeared to work elsewhere.

"was told by a doctor that he could go to a clinic"

It's the endless mutton-headedness that impresses me. Just the other day Boris was telling journalists about the importance of social distancing. The journalists were, of course, packed into a room.

Have you ever considered that to be by design?

+1, that's just a basic intelligence test

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You can't contact trace when your metro country has 10,000 cases.

You can contact trace when you have 10 cases.

I'm not really sure what our endgame is, but I think it's to suppress the virus to the point where we can rationally do contact tracing.

"You can't contact trace when your metro country has 10,000 cases."

Coronavirus: Singapore develops smartphone app for efficient contact tracing

https://www.straitstimes.com/singapore/coronavirus-singapore-develops-smartphone-app-for-efficient-contact-tracing

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I think the appropriate next steps are:

1) Continue blocking and tackling to ensure those folks who are working in essential roles can continue to do so and can focus on their jobs. As managers its a bit difficult to keep people on task when they're thinking about food shortages, childcare, etc. We will continue to find ways to keep them employed but could use an assist from thought leaders and influencers to help move general public from panic mode to "make prudent decisions" mode. Mantra should be something around "be safe, be smart" and help folks get educated about the ability of our supply chain to support ongoing delivery of food & supplies.

2) Rather than crowd-source solutions maybe we do need 10%-20% less democracy and let the experts figure out if forbearance, AD/AS, PSST, UBI or other frameworks/concepts are right way to approach. Cowen, Caplen, Tabarrok, Cochrane, Kling all have different ideas and keep airing these different ideas. i would hope they're opening up a conf call and pressure testing these so they can present something back to decision makers.

3) I don't see too much debate about how flat we want to flatten the curve or where we are in this process*. Basically this means there isn't a lot of light at the end of the tunnel - need smart people thinking about this and modelling this so economy/businesses can start making plans. Right now nobody knows if we're talking 5 days or 55 days. Very difficult to make decisions when such critical data is missing.

*could be my bubble just isn't large enough so i'm missing this.

3. This has come up multiple times in the White House press conferences. They are saying mid summer.

And yes, every single initiative by local politicians to attempt to exert control over their populations needs to be considered in this light. This is going to have to last till mid summer. Extreme or unreasonable or onerous or plain silly impositions will fail, catastrophically.

I've been banging on this drum for a month now. Is the difference in spread due to the design of the interface to health care? Travel has similar characteristics; large numbers of people crammed together in some small space waiting for something. But health care is worse; by definition you are there because of some health issue, either meaning you are weak and vulnerable to infection, or carry it, and the people who are going to poke and prod you have the highest likelihood of anyone of being exposed.

Instead of moaning about people in parks, set up a damn fever clinic in the park where people can get a very simple primary indication, fever or no fever. And very clear directions on what to do. As tests roll out, get them done. China didn't have a widespread test either; they set up a graduated health care system where they would channel people into specific courses of action all starting from a point of contact far away from sick people and health practitioners.

Instead of using the blunt instrument of state power to try to control people, tell your public health officers to get out there to show people how to do things safely, with the reminder that if you don't, they will be eating you in a month's time.

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It would be really great if we could do this. It would take a huge mobilization though, and what, drive-through sampling for millions of workers?

But the sad thing is we have neither the test nor just isolated workers waiting to be tested.

The important workers at least, the potential vectors, are out there still working, as they must!

What we really need right now is to get (good) testing to supermarket checkers, and those workers keeping takeout only restaurants operating. And any other vital worker with a large number of daily contacts.

And make sure takeout drivers for Uber/Gruhub/etc get paid well.
I just got into a discussion with a friend of mine who is an uber driver who is now out of work - said he wouldn't do delivery driving because it's not worth the money.
If someone delivers food or groceries to your house, that's service, tip them the standard 18%.

"If someone delivers food or groceries to your house, that's service, tip them the standard 18%."

This would be a great time, to just drop a holiday level 30%+ tip.

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There are a few levels of tests. The cheapest and easiest is to take the temperature, but it misses pre-symptomatic people. It might work for, say, patrons to a theatre or restaurant.

Doing a biological test might be done daily but reserved for people with the potential of infecting lots of people, or those working with at-risk populations.

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All based on immunity. Do we know that there is immunity? How has that been determined?

It’s determined by finding antibodies to COVID-19 in your blood. I believe it’s been established that recovered patients have “ some “ immunity. I think a serological test to do this exists.

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I was in a Zoom group last night that was discussing what products might be in demand following the end or wind down of this episode, under various scenarios.

So, one of the questions was: What habits will be develop now that will carry over AFTER this is all over, and what things which we are required to do now that we will not want to do later because they are associated with this in home event.

One of the most obvious changes is the increase in online meetings and the conversion of some groups to online video formats.

If this becomes a habit, or people see more value in it, or have been introduced to it, then what does this mean to the hotel, airplane and travel industry.

What does it mean for convention spaces...should they have video crews or contracts with ones to simulcast conventions or be prepared to do so

Will the diffusion of new product introduction be slowed down? Instead of conventions to show off new products, will there be more youtube like demonstrations.

Will offices be things of the past. Will we go back to cubicles or closed office spaces.

What habits are you developing in confinement that you will likely continue after this is over?

How will your work life have changed?

Interesting comment. It seems very likely that online school, church, etc will be much more important. Sorry kids, but this might be the end of the “snow day”.

I think health and fitness is going to become way bigger than it is.

Traveling is gonna take a big hit for a while.

I can’t believe something like second life or whatever that was called hasn’t already taken off... where u can see people virtually in a “world”. Fortnite is used by kids, but it’s a shooting game. That’s not what people are after really.

People are not going to look at viruses and medicine the same. Anti inflammatory products will become more important.

Hunting and outdoor activities will get bigger. Survival stuff will go even more mainstream.

STEM is going to be the next IT. Even more than it is.

Another big thing is Church. I am daily Mass type myself. Once I got in the habit... I fell in love with the silence and darkness and the meditative aspect of it early in the morning. At my parish, early morning daily Mass has like 25 people at it (the same people over and over)... you should see the number of people virtually attending daily Mass (hundreds). Now that’s not Mass but I think people might get in the habit. Even more so probably for Protestants... who don’t do daily service... they are now.

Could you imagine if a wearable device like a Fitbit could detect the presence of viruses somehow? Talk about permanently solving the testing crisis and linking that to medical care. Obviously that’s why google bought Fitbit but imagine if...

What else, this is fun.

I am actually interested in the fall of in contributions to non-profits, such as churches which administer to the poor, and other non-profits that have relied on attendance, such as museums.

It's not just businesses we may lose but also social infrastructure.

I am heartened by how some of these institutions are going more digital, which, after this is over, may actually result in more engaged members.

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NB. The churches' expenses don't go away. If you can, make up the weekly envelopes and tithing.

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For 45 days or less, everything goes back to the way it was. There will be a modest shift towards telecommuting since a lot of locations will be forced to seriously implement it for the first time.

However, certain already marginal industries/cases might be drastically effected. This could permanently downsize the theater industry, unless Hollywood can get over their greed and drop down their percentage cut.

Permanently boost Amazon, Netflix, Disney+ etc as a lot of people who have never tried it, now decide to use the free trial version for a week.

On a smaller note, there's been talk for decades of reverting back to Brass (copper) door handles for hospital, hotels and such. This might be enough of a push to implement that small but useful change.

Amazon has been pushing robots into their plants for some time, this will prove yet another reason to continue that push. However, it was something that was going to occur anyway, so I'm uncertain if this well push the schedule ahead by very much. It might well push automation ahead at McDonald's and other fast food restaurants. This might significantly effect their economic calculations.

I think overall for less than 45 days we'll just see Fast Forward on a lot of already existing trends.

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... all this 'magic' testing has severe limitations.

A person who tests negative on one day ... can contract Coronavirus the next day -- it's a dynamic infection environment that spot-checks can't keep up with

it's logistically impossible for any nation to seriously test and track a large population

these tests have an unknown margin of error

there are no "experts" on Covid-19 -- everyone is relying upon very limited factual information

Right, even a good test is going to have partial deployment, meaning that isolation will be partial. That cannot bring cases to zero, at least not fast. But it does help to flatten the curve.

It seems to work in South Korea. Unless the number of cases is huge, and if people wear masks, the probability that anyone testing negative goes positive the next day is low.
Also infections tend to cluster. You test more around cluster situations.

I tried to say "right" to jeremy and then spin it in this direction.

But think about the logistics of getting tests out to taco workers at a truck stop in New Mexico.

Any testing will help, but universal and frequent testing is a heck of a goal, as Daniel notes.

Is that harder or easier than testing stall workers in an aboriginal rural area in Taiwan?

Or Japan?

I don't know, but I think "miles from major hospital" might matter more than "percent urban."

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And geez, drive-though testing NIMBYs

https://www.darientimes.com/news/article/Town-of-Darien-to-offer-drive-through-coronavirus-15140106.php

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Not quite. South Korea has apparently done an effective job of containing the virus, as evidenced by the number of cases going flat under a regime of rigorous testing and surveillance and lack of strain on their medical system.

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If you asked me a month ago, I would say testing all your food service workers daily is insane.

If you asked me today, I'd say it's a lot cheaper than putting a quarter of the economy on lockdown.

Has any place shut down food service? I'm not aware of any. "Lockdown" means a shutdown of public transportation and places where people tend to gather, including most offices. Take-out service from restaurants and food stalls is still largely available, as is prepared food from supermarkets.

We're not in a heavily affected area and the restaurants aren't shut down, but their customer base is a fraction of what it once was. Many, people are eating at home.

I think that's now the main reason supermarkets are crowded. I *think* the hoarding is reduced, but the volume of need has to be higher.

Anyone who used to eat lunch out now has a 1/3 higher grocery demand.

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All those are good ideas.

If this is a multiple testing model, I assume the government will be paying for the tests, or will it be the employer after the initial test, or the employee in order to be employed, or the gig worker.

Since there is a herd benefit and externality, it would probably be the government all the way.

Will continuous testing lead to risky behavior (I had to put that one in there just for the fun of it because that is often how people who oppose something frame it).

If an employer does not test, and a customer becomes infected, is there liability.

Basically, what you are trying to do is make an information market where services can safely be sold.

Wear your GoodHouseKeeping Seal of Approval proudly.

If the government can get the economy moving again, paying for rigorous testing is likely to be a bargain.

We will have to deal with both a) dumb idiots and b) malicious cheaters. The fix for each is slightly different.

Will have to have certified testers, otherwise you run the risk of scams.

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Has anyone updated the positive side of the coronavirus? Apparently, Venice's canals are super clean; I wonder if there have been many fewer cases of the flu (based on the hand washing, etc). Are there any silver linings that we should take note of?

Probably fewer bar fights, car accidents, rapes, and street robberies if people are not out.

Probably more auto thefts.

Probably more house or apartment fires.

Probably more divorces by people having to be with each other each day.

Whether there is more or less sex will be apparent in 9 months.

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Fewer marriage events and more funerals.
Video streamed funerals and video condolences and memorials that will look like infomercials for the dead.

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Decline in other communicable diseases.

This raises a question: Some countries have national two week holidays, or months, like in France, where everyone leaves Paris. Can we learning anything from these customs that might be predictive of purchasing behavior, for example, as people come back from vacation.

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LA air quality is much improved (rains probably helped)

https://metro.co.uk/2020/03/19/coronavirus-ends-las-notorious-smog-air-pollution-people-stay-home-avoid-roads-12424002/

Maybe with more telecommuting we can keep that going.

Oh, and I can take off anytime I want to drive across LA .. on a Friday!

That is really something.

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I've read that the canals in Venice aren't really any cleaner, it's just that the sediment isn't being stirred up by boat traffic. This makes sense as a shut down of two weeks isn't long enough to clean the canals in any appreciable way.

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Maybe if we promise while captive to watch the impeachment hearings this time, they'll let us out from martial law?

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Best comment today.

I meant peri's comment above, very funny.

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I've started a project to leverage the infected / recovered called ImmuneCorps
https://github.com/marknagelberg/immunecorps

The idea is to build an application that Health Authorities can install that will allow them to track the immune and reach out to them. It would be deployed on a public facing website so volunteers that have recovered from the virus can apply and be verified by the Health Authority. Potentially, citizens could also make requests of the immune.

Contributors welcome, especially people knowledgeable about health authority needs with respect to tracking the immune (perhaps the idea is flawed or unnecessary). Anyone can fork or take the idea and build something themselves as well if they think this is a good idea and they can build it faster.

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I totally agree Alex. Why aren’t our experts studying South Korea? Have ubiquitous cheap test and a sanitary corps of workers testing and tracing with many accredited labs to test ( turn around is 6 hour in Korea , from test to result in the database) Shutting down the economy is a disaster that will cause a lot of pain and misery. Test, trace, wear masks.

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If the appropriate testing was available, we could issue badges of recovered to people who have overcome the illness. These people could socialize, go to restaurants, sports events, and cultural events. Their gatherings would be small at first but would grow and function as preservations of our way of life till the threat abates.

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I want to know why it takes so long for tests to get approved in the US. Here in Irvine we have a company already shipping sample serological tests, but only to overseas where they can buy them! Madness. (A close friend works there.)

https://www.biospace.com/article/releases/biomerica-begins-shipping-samples-of-10-minute-test-for-covid-19-virus-exposure-/

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anybody else remember when uncle paulie from new york city with currently the highest number of covid 19 infection in the u.s. said the midwest was doomed and everbody should just accept it and let it happen?
we do!

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That 80,000 figure is per day, correct?

Because otherwise, that number is just a joke.

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"A vaccine is also possible and perhaps faster [tweet link] than most people think."

A vaccine would be given to healthy people and must be proven safe prior to administration. When you factor in the clinical trials and observation periods necessary to prove this you're looking at 12-18 months, more likely 18-24 months. The tweet linked doesn't offer any way around this (but it does offer some reasoning why there will be pursuit of a vaccine).

It seems unlikely the US will have an approved vaccine before the 12-18 month time frame. It's quite possible that other countries will.

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I have no been able to run this by anyone who would know, and I assume that it is wrong, but could we batch test for Covid?

Suppose we had a 100 workers to test. Per the CDC back on the 12th we had 40,367 test back on March 12th. At that time we also had 1697 confirmed cases. Using those numbers we expect 4 workers to pop as positives, ideally they would be retested, and then isolated. That would take 104 tests.

Instead we might comingle samples and test all 100. Somebody in the bundle is positive. So we test them in 50s. Each half is positive, so we go to 25. Again all positive. Now we go to 12 and 13. Here we get some luck. We get are positive only for two 13s and a 12. With split to two 7s and four 6s. We get 4 positive here. We split those down again, get another and now we have two positive 4s and a positive 3. We split again and have a positive 1, three positive 2s. Now we run one last batch and find our four infected folks. In total we ran rounds with 1, 2, 4, 8, 6, 8, 8, 6, and 6. Grand total was 49 tests for 100 folks.

Doing the same exercise with a 1% infection rate. Well we start at 100, go to 50 and one batch is clean. Split another and clear 25 more folks. Split again and clear 12. Split again and clear 6. Split again and clear 3. Split again and clear 2, and test once more to find our single infected individual. Total tests used: 1, 1, 1, 1, 1, 1, 2. Now we used 7 tests to clear 100 people. The lower the base infection rate, the more we can save test count by taking multiple samples and running them in a single well.

This assumes that the limiting step are wells for the RT-PCR and also that the false positive rates are not significantly impacted by having multiple samples in the mix. I would be curios as to to thoughts of anyone who has more experience than I with the technical specs.

If we wanted to test everyone in the country, and maybe repeatedly, it seems like a logical shot would be to just take 5 or 10 fold samples and then batch test them with RT PCR so we minimize the time on the thermocycler.

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Pay me to be infected by the virus and pay me for my antibodies.

$100 to infect me
$50 for blood donation

Hit me up.

don't rent yourself out too cheaply
in the seatle trial they are paying 4500 American dollars to be injected
with an altered form of the covid 19 virus

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