“Social Distancing is Working so Well!”

How do you feel about that statement?  I take this as one psychometric test.

If your reaction is: “My goodness, these are tragic times but it is splendid and noble how we all can come together and sacrifice for a common endeavor!”…well…

…you have failed my test and I will suspect a wee bit of mood affiliation.  Most likely it is bad news if the relative safety (for some) of the current moment comes from social distancing.  Because at some point social distancing must end, or at least be significantly curtailed, and then a higher danger level may well reemerge.

Possibly you have inside information that a cure will be ready next week, but somehow I doubt it.  You are happy because you like something about the process.

Alternatively, if you hear “social distancing is working so well!” and immediately feel a deep sense of foreboding, and begin to calculate whether good short-term results are correlated with better or worse long-term results.  And then you calculate how how long the distancing can last for, due to governmental budget constraints, and then try to figure out what kinds of progress we might make in the meantime while the distancing lasts, and then start worrying about how reliant on social distancing we are becoming…

…But then you undertake a second-order calculation about how the greater danger spurred by the forthcoming decline in social distancing also might spur innovation…

And then you think “would it not be better if the current progress came from a more sustainable source, what might that be, how about faster than expected herd immunity amongst a relatively small group of heterogeneous super-spreaders, now what is the chance of that?”…

…and finish your analysis confused…

Then you are my kind of weirdo.

We are living in a time of psychometric tests.

Comments

Clearly Tyler is handling this stress very well.

In the last 60 days we've seen governments, central banks, and the job market enter economically unknown territory for which models are scant and for which no economist can genuinely predict what comes next. It's all pie in the sky now. I would wax philosophical too.

Don’t know if this is correct, but it could be checked, unlike much of the blather clogging the airwaves.

https://www.timesofisrael.com/top-israeli-prof-claims-simple-stats-show-virus-plays-itself-out-after-70-days/?fbclid=IwAR1Cj-N0e4eLKUNsY7Gn7lt1i5Oph9uMwBVZCtYGz59rAZUWRbzvprsiNaE

400 homeless were checked in Boston...36% tested positive and were asymptomatic. A news anchor in LA posted a picture yesterday of him sitting in traffic in LA. People are out and about.

Or positive and pre-symptomatic? Wouldn't they need to keep an eye on those people for a while to see if they develop symptoms?

+1, I like Tyler but he's been picking some weird fights over the past few weeks.

I don't mean "he should quietly receive the wisdom of epidemiologists" or "he should care more about contract workers at universities". I mean the way both of those points were raised seemed...oddly imprudent for him? Maybe just stress?

The highlight was 'Fix this now. I mean you!' on March 14.

Ambiguity and confusion are the only logical stances on the coronavirus right now. Beware those who are firm in their convictions and have absolute answers!

Concerning the basic public health principles of handling an infectious disease, my convictions remain unshaken. Unless you find that what happened in Taiwan or South Korea have nothing to do with public health principles.

It has been bizarre seeing how many people, even those with high GRE scores, don't have the basic awareness of public health principles I thought any American 8th grader was taught. The record of the U.S. in the 20th century in this area was a true triumph of American society, worthy of true civic pride of being part of a great nation.

What is all this stuff about GRE scores? The only Multiple-choice No. 2 Pencil Test that counts is the PSAT. That's how you get into National Merit, and Bowdoin College invites you to apply.

"Ambiguity and confusion are the only logical stances on the coronavirus right now. Beware those who are firm in their convictions and have absolute answers!"

+1, yes there are no sure answers.

Sure answers? Maybe not.

Solutions? The Taiwanese and South Koreans appear to be handling thing reasonably well. Austria, Denmark, and Germany all appear ready and willing to see whether they too can deal with this virus as they reopen. None of those countries may have a sure answer, but they do all seem to have functioning public health systems, able to test, track, and isolate infected people in a way that either kept the disease from spreading in uncontrolled fashion in the first place, or they now feel able to master the challenges involved, even if they would not claim to have a sure answer.

Denmark and Germany both have higher covid deaths/capita than does California.

Surely premature reopening is the more economically damaging option, assuming it leads to a second general closure?

And lower than NY, NJ, Connecticut, Louisiana, etc.

The head of the Robert Koch Institut has said that Rnought is around 0.7 currently in Germany according to the Guardian, meaning that the Germans seem to think that all of their measures have been effective enough to see what happens if things are reopened. It would be strange to ask a German about social distancing, since that was only one measure put into place. And the Germans undoubtedly have the testing capability to carefully track what happens as they reopen, instead of wasting even a minute of time debating about the panoply of public health measures employed during a global pandemic.

And death rates are a somewhat silly measure to be honest, with the American debate appearing to be an echo of the Vietnam War era body counts. Pandemics are not wars.

Deaths per capita is the only reliable statistic.

In places with inadequate testing. Many places have a hard time accurately recording any deaths outside of a hospital or nursing home, but one can see a rise in total deaths with a certain lag, certainly.

In places with adequate testing, the reliable statistics are instead delivered by the tests, along with a functioning public health system that attempts to apply basic principles to keep viral spread in check.

Germany does not have adequate testing.

Good enough to be confident that Rnought is under 1. And its current test rate per million is 20,629 according to Worldometer, in contrast to 10,333 for the U.S. (as a whole).

However, German testing is good enough to be running a 100,000 person study in Heinsberg using antibody tests. That study is part of the data being used to guide German re-opening measures.

No testing is needed at all to be certain that R0 is below 1. You can simply count bodies at the morgue to track that.

See California, very little testing and R0 is below 1 for sure.

The stat to watch for testing is not tests/capita but rather what % of tests are positive. Germany’s ratio of positive tests is too high.

you are a sophist
just because California as a state is doing better than newyork doesn't mean that there aren't hotspots where
ro is > 1. testing is needed and useful

'You can simply count bodies at the morgue to track that. '
No, it does not work that way. People are still dying from other respiratory diseases of course, and without testing (if only to rule out those other diseases and causes by using flu tests, etc), you have no reliable data at all, apart from the number of dead people.

'Germany’s ratio of positive tests is too high.'
Which is why they shutdown, of course. They were no longer able to trace and quarantine as the first wave kept growing.

Unfortunately, Covid is sufficiently deadly that simply counting bodies at the morgue is useful.

Also... I'm confused as to why you held up Germany as an example of a nation with high testing when you so readily admit that their testing is inadequate.

Only Taiwan, Singapore, Hong Kong, Korea have high rates of testing at this moment, so far as I'm aware.

Korea currently has half the rate of testing of Germany, according to Worldometer. Mainly because it has many fewer cases, and thus less need for testing.

'when you so readily admit that their testing is inadequate'
Testing simply allows you to identify the sick, no more and no less. It is only the first step, not the last one. You may be a bit confused on this point, to be honest. Testing is important when you can still trace and quarantine people. In isolation, testing is essentially meaningless as a public health measure.

Metric for testing is: (% of total tests which are positive)

Germany: 7.9%

Austria: 8.2%

Japan: 9%

Korea: 1.8%

Hong Kong: 0.7%

Taiwan: 0.8%

Italy: 13.8%

Get the picture??

For comparison:

US: 663K/3,401K = 19.5%

The US still is lagging in testing.

Wonder if it would be advisable to stockpile tests for use when reopening.

Yes, it probably would be advisable. But unlike other countries, which are using the lockdowns to stockpile medical supplies and tests, the US seems to have no plan for reopening beyond the president bleating about it and allowing people to literally riot their way out of social distancing. So I'm not optimistic.

None of those nations are very diverse, except possibly Germany, ironically. However, being obedient is part of German culture.

A diverse population with autonomy and freedom is the best place live, imo, but perhaps not the most hardened against viruses. As some have droned on about recently, we tend not to obey the dictates of experts. Perhaps there is some selection pressure to deselect those traits via a viral pandemic. I dunno.

West coast USA seems pretty diverse. We commenced self isolation and social distancing before the experts recommended it, and in large numbers.

Yes. I am in Central California. My employer closed and I have been home for over a month.

We have many cheaters - one of my kids is one.

The Tyler of 2015 and earlier had more intellectual scruples and enthusiasm for knowledge, maybe closer to where Scott Alexander is now.
As your audience becomes larger the temptation to preach must become irresistible I suppose.
Also, most everybody has gotten dumber and more arrogant since 2015 for some reason.

The puppet strings are becoming just a bit more obvious as they are pulled.

The discussion starts to become focused on things like a "relatively small group of heterogeneous super-spreaders" or a small group of protesters, while diligently ignoring what is happening at meat packing plants, where super spreaders seems meaningless when 20% of the workforce is infected in less than 2 weeks, and where the protesters have been the hundreds of workers at such facilities not going to work because they fear spreading a disease to their family members.

Let me clarify: I miss the old Tyler and hope he returns.

Googling the Chinese ownership of the Smithfield plant inevitably prompts the thought that maybe when things are better, it could reopen as Long Pig.

However, I don't know that it totally invalidates the superspreaders thing; alt right Twitter implies it is staffed by refugees and immigrants, and there could be international travel or social custom reasons for the spread there, as may be the case with Sweden's heterogeneous numbers.

Or maybe Mr. Wan Long did not provide protective gear to his workers.

However, the makeup of the plant workforce could be fake news.

Among the numerous facilities being closed are American owned - Tysons and Cargill - or Brasilian - JBS - ones.

Smithfield came a bit late to the party, yet somehow, the news only started appearing nationally after people started noticing what was going on in their stores.

And the reason for spreading is found in the headline of a Reuters article 'Elbow to elbow:' North America meat plant workers fall ill, walk off jobs

I would say, may we hope for different and better conditions in future, but I guess that would contravene the point of our beloved globalism. A continuing fresh source of labor obviates change .. Ironic? I don't know. I don't eat much animal protein so my brain doesn't work as well as the rest of y'all's, even within its own limits.

'but I guess that would contravene the point of our beloved globalism'

This is a non sequitur, unless you honestly think the American meatpacking industry, using American livestock and poultry fed American grain somehow represents globalism. That midwestern union busting owners suppressed wages as far as possible is true, but that was happening in the Reagan Administration. Facilities like Tysons has in the south never worried about union busting in the first place, and had no need to import low paid labor, having plenty available already.

"Facilities like Tysons has in the south never worried about union busting in the first place,"

This makes me think you've never been in a Tyson facility. They are packed with hispanic immigrants of questionable status.

Why would Prior_approval even care? He has a few axes to grind and by God he’s going to grind them.

Props to him for getting the Reagan administration, Mercatus and Tyson foods in back to back comments.

We should start a prior_approval axe grinding bingo.

https://www.newyorker.com/magazine/2017/05/08/exploitation-and-abuse-at-the-chicken-plant

"would it not be better if the current progress came from a more sustainable source, what might that be, how about faster than expected herd immunity amongst a relatively small group of heterogeneous super-spreaders, now what is the chance of that?”

Anyone have any idea what this means? Social distancing has to help, it is impossible for it not to. On the other hand you have this suggestion, that somehow a small group of super-spreaders distributed throughout the population could achieve "herd immunity"?? In order for them to achieve "herd immunity" (just regular immunity?) they would have to all be getting sick. If his idea is that super spreaders continue to go out and get sick while the rest of us stay home and are therefore safe from them, that is still a victory for social distancing. It just means social distancing works a lot better than we expected.

I found it a little confusing - maybe "clique immunity" would be a better term for what he's getting at.

Seriously... this was one of the stranger MR posts I have read in a while.

When will there be a post about chicken hawk test? We need herd immunity... now you go do it while I stay in my safe house.

Agreed. Now please help us get back our rights to "go do it", as you say. Petition your governor, or something.

>Clearly Tyler is handling this stress very well.

He's doing better than many other Dems, but as you can see here, he's still very much praying for doom.

Because talking about social distancing working so well seems silly in light of this - "The country’s daily death toll hit a new record of 4,591 people yesterday, according to the Wall Street Journal. That figure is nearly double that of the previous record of 2,569, which was set on Wednesday."

Deaths lag infection by an average of 23 days. The deaths today reflect infections from late March.

They represent a serious increase, yet here we are, debating whether social distancing is open to reasonable discussion.

looks like Dr. Cowen and Dr. Dylan are passing their psychometric tests

https://www.theguardian.com/music/2020/apr/17/anne-frank-indiana-jones-bob-dylan-new-song-contain-multitudes

so anybody wanna confess that they adjusted our televisions

When is the last time he left the house? Just for a smoke and a coffee?

What do the data mean? https://www.theatlantic.com/technology/archive/2020/04/us-coronavirus-outbreak-out-control-test-positivity-rate/610132/

Social distancing is working well but not for the stated objective

It’s stopping the virus from
Moving into new areas, but doing nothing to stop the growth of virus in areas already well established.

@Charlie - what is your prior, what 'stated objective' is there? It seems to me the question should be: "Social distancing is working well, COMPARED TO THE ALTERNATIVE", where you list the alternative.

Bonus trivia: C-19 causes lost of smell and taste *even* in young people. And some experts say this causes subtle and permanent brain damage that can lead to Alzheimer's and other brain diseases in old age (speculative). Similarly, many C-19 victims report hallucinations and hear voices. Be afraid, be very afraid*

* as a member of the 1%, I'm looking in this crisis to buy assets cheap, so FUD is my friend, but so far markets have defied gravity.

"Similarly, many C-19 victims report hallucinations and hear voices."
That's not unusual for a disease that causes a high fever. It's just that most people don't experience these type of diseases normally.

Markets didn't defy gravity very well up until March 23. Then the Fed and Congress brought out the big guns and you missed your window.

So you can keep spreading nonsense about taste and smell and liquifying insides but you're not gonna get that entry point again.

Social distancing is nothing but a way to buy time so that local health authorities can try to keep the virus in check.

It was never an end game, and the EU countries that are reopening are not relying on social distancing of the sort written here, they are relying on their health agencies being able to test, contact trace, and quarantine. This seems an odd discussion in a way, much like asking someone's opinion about hand washing. Especially since social distancing involving large gatherings is now firmly establish as a necessary preventive measure, following the experiences of churches in South Korea, Karnival in Heinsberg Germany and New Orleans, or meat factories in America most recently. Passenger and military ships are another example of what happens in enclosed spaces with lots of people, and are best avoided.

Defining what social distancing means would at least be helpful.

The vast majority of young people I know have been sneakily breaking social distancing to hang out with friends, family, tinder dates, etc... almost like an underground network of superspreaders growing their herd immunity to save the world (they just don't know it).

Here in WPB, Florida (and I’m assuming the rest of South Florida) social distancing is the Big Lie. Cars all over the road. Common for a crowded intersection or the need to make a u-turn. Not only stores, but take out restaurants, places like Home Depot have half filled parking. Maybe 50% of the people are wearing masks. And when I see someone without a mask they’re almost always +50 year old.

I'm in Miami and have observed the same. The notion that "we were better at social distancing than anyone could have expected" is absolutely laughable.

(Sorry for long post. Beyond frustrated and have zero outlet to voice it.)

A half hour ago I was waiting in line at a popular local donut shop to pick up an order.

There’s 7 people in front of me, 3 off to the side, and a cashier. Two masks, me and a overweight guy. No mask for the cashier handling food. Place is the size of a big walk in closet. "Social distancing."

I’ve been reduced to running food to make ends meet (and it’s not working) so we can pretend we’re “doing something” and #flattenthecurve. Security theater.

NY hipsters and DC think tankers are lecturing me to #stayhome and telling us to #lockitdown. A month ago these same people were telling us shutting down flights from China was racist and we should really worry about the flu. The memory hole is deep.

If I talk about trade offs I’m a Nazi. This is the largest wealth transfer in the history of civilization, from the relatively young and healthy to the old and sickly (often self-induced through bad habits). No one, most of all economists, is talking about it or the long term implications. Supposedly the economy has an on/off switch like a lightbulb. Before, certain economists, and the media, said inequality and poverty (the American kind, with a iPhone and Air conditioning) caused "diseases of despair." 20+ million newly unemployed... #stayathome.

I’m not a fire breathing Trump-tard, I don’t doubt people are dying. This isn’t a globalist plot to prevent Trump from winning in November. I believe in the scientific method (not in "science"). But, I’m totally shocked at the willing and eagerness of the ruling class to destroy the lives and livelihoods of millions.

I say, put them up against the wall, all of them.

I'm with you, in that I believe in the science of pandemics. But I am also routinely reminded in America that we "aren't allowed to have nice things" because a small group (superspreaders) will ruin whatever nice things we have. So shut the whole thing down because people can't cough into their elbow or stay home when they have a fever.

Yes, yes, asymptomatic transmission...masks for all, then.

If the superspreaders are the problem why not severe punishments for knowingly going out while sick? I’m sad to say I believe there’s a lot of schadenfreude going on. The bluecheck marks inflicting their revenge for the last couple years (I’m only partly joking).

I haven’t seen any talk of an acceptable death rate. What is it? Does it need to be zero?

I saw an article yesterday (maybe linked on MR?) that pointed out the goal posts for social distancing have moved so far since the initial proposition was made. Remember all those bell curves with no scale on the X or Y axis that said we had to keep hospital beds open to those who need them?

Well how many states are under capacity in their ICUs? I live in CO and I know they are doing OK. Maybe NY/NJ needs lockdown...Now it's a completely different conversation. Now it's "minimize deaths no matter the cost". When originally the whole point was to not let anyone die for lack of a hospital bed/ventilator.

As to your other point (punishment for going out sick) it seems fair enough to me. I have a thermometer I can take my temp every morning. But then again the "blue checkmarks" don't want voter ID requirements because it might cost $10 so maybe I'm showing my privilege by suggesting everyone buy a $7.99 thermometer from Walgreens and take their temp regularly?

Btw I don't literally think people are saying "minimize deaths no matter the cost", even if their actions say otherwise, but my larger point is I don't hear people discussing hospital capacity, they are discussing infection rate and death rate...

Social distancing has mutated into a de facto political movement, and political movements, like bureaucracies, tend to develop survival mechanisms. The goalposts are moving in order to stave off obsolescence. This doesn't require a conspiracy or malfeasance, it is usually purely emergent.

Well put, C.S. Nothing really to add, but I agree wholeheartedly and am glad you posted.

The answer is going to depend on whether one defines social distancing simply to mean the tactics of physical distance and masks, or more broadly to include stay-at-home orders. The terminology has been getting blurred.

This whole thing might end up being a net-positive if the world resets how it interacts with China.

@m - especially when it becomes clear C-19 virus was released in Wuhan by accident, as the Union of Concerned Physicists thinks is possible and Bayes theorem almost guarantees. Watch for this to become a hot topic before the election.

You need to stop impersonating the real Ray Lopez. You're over-doing it. The real Ray is not that whacko.

The burden-of-proof is upon those who claim that “social distancing is working so well!”.

So far, there is no objective proof that attempts at mass social-distancing has significantly diminished the incidence of Covid--19 ... versus a passive, zero government imposition of masssocial-distancing dictates.

The so called 'flattening of the curve' is merely an attempt to 'delay' the spread of infection ... to permit better medical response preperation.

exactly. thats the goal. and it is succeeding

it’s weird how intent some people are to obscure that.

But to quote Monty Python, "I'm not dead yet!"

And that's always something.

There's been considerable mission creep, and the goals of the shutdown now extend far beyond simply de-stressing the medical system.

No. The situation persists because we have failed to achieve the simple, logical, and clear steps towards being ready for the next phase.

Situational awareness. Testing capacity. PPE and equipment supply. Coordinated response cabability.

Still not that much better than early March. In many ways, worse. Because we have a public health system that is stressed and stretched.

Yes, we largely beat back the first wave. But it would be exceptionally foolish to rush back out now.

First wave has not yet been beaten back. Curve in NY has been flattened but not yet fallen. Still a ways to go, “first wave” not yet beaten back.

But it will be.

Pointless to roll out more tests now, under lockdown. Tests are for when we are opening up again.

otoh
its not pointless its the right time to establish a workable testing system and to determine the sensitivity and specificity of the tests
and figure out what the test results mean

Asian nations have already done all of that legwork for us. We know exactly where we need to get, how to get there, and what to do once we get there.

For now we wait.

you are a sociologist
at this point in the viral pandemic we don't actually know too much at all about the virus, asymptomatic spread, testing sensitivity/specificity, case fatality rate, method of spread, effectiveness of the lockdown, antibody response or how to implement wicespread testing or how to treat the disease

Via trial and error we already possess vast information on which measures do and do not work to contain this disease.

We will continue to gather more data as time goes on.

other vast information we don't know includes
- how much asymptomatic spread
-how much airborne spread
-efficacy of masks
-how much immunity after infection/possible reinfection
all stuff that is gonna be determined by testing

+1

That's pretty much my sentiment, also. "Compared to what?" is the right question to ask in this situation.

We don't really know if social distancing is doing much of anything. It is definitely strong enough to crush the economy, but I am quite open to the view that it isn't nearly strong enough to make more than a slight difference in the spread of disease.

We don't?

The lockdowns worked—but what comes next?

That would be from the American Association for Advancement of Science.

I find their "analysis" to be more guesswork than fact based. Not really their fault that there are not more controlled experiments, but that is not an excuse to overestimate confidence levels.

More anti-science anti-rational nonsense.

Can there truly be any doubt that the massive, rapid, unprecedented reduction in contacts has had an appreciable impact on the potential spread? Really, any doubt whatsoever?

What, do you propose that a virus that thrives mainly on close sustained contact (or on repeated dense incidental contact) suddenly walks down deserted streets by itself and passes through walls? Good God this is absurd.

Sure there's lots to argue about cost/benefits, timing and extent, and certainly about what comes next.

But the fact that there are trolls, bots, and morons spreading doubt about the nature of the one smart (of not desperate) thing we did is unsurprising, but exceedingly depressing.

"Can there truly be any doubt that the massive, rapid, unprecedented reduction in contacts has had an appreciable impact on the potential spread? Really, any doubt whatsoever?"

In a word, yes.

In theory, social distancing should help but when you compare between countries that are doing this and ones which are not, take Sweden and Switzerland for instance. Their rates of infection and death don't look very different.

It may be that the virus is so contagious for the small subset who can become very sick, that our efforts so far have made little difference. There is certainly not enough actual data to make any kind of sweeping statements yet.

As I keep pointing out, the places that have the worse rates of infectiousness and death are places where there is more physical contact during greetings. Swedes and Germans don't do that cheek kissing thing - they shake hands. Japanese people just bow.
The evidence suggests that to be contagious requires prolonged close contact - or maybe physical transfer of saliva. It shouldn't be shocking that leaning in and making a kissy noise close to someones face might make this more contagious than bowing from 6 feet away.

It's possible that the only thing needed to flatten the curve is not touching other people or engaging in long face-to-face interactions - not hiding indoors or shutting down non-essential businesses.

Can there truly be any doubt that the massive, rapid, unprecedented reduction in contacts has had an appreciable impact on the potential spread? Really, any doubt whatsoever?

Of course it had an impact. The issue is whether the same impact could be achieved with less severe restrictions.

Sure, that's a fine parlour game and fair question for debriefing later.

But that was not the USA's reality in late March/early April 2020

What about mid-April 2020 ?

Your the one who keeps talking in the last tense

Social distancing gets us to a sufficiently low level of infections that it can, hopefully, be controlled by public health apparatus.

My problem is the baseline scenario was "70% of adult males don't wash their hands after using the bathroom, nobody wears a mask in public, and it's OK to go to work with a 100F fever."

We went straight from that world to "do not even look at somebody 6 ft away from you."

Where's the realistic middling scenario? Everybody wears masks, washes their hands, avoid indoor crowds of more than 50 people, sick people stay home. Social distancing may work great, but we may get 80% of the benefit (which hopefully means R0<1.0) for 20% of the cost.

Between all of the states and EU nations, I am confident that trial and error will show us which measures have highest ROI.

I hope so.

This is one of those times where it becomes obvious that the world, the media, forget how heterogeneous the US is. New York City =/= the United States. Cuomo has his hands full while the rest of us should carefully get back out there.

Get back out there? Don't most parts of USA still have active outbreaks?

Depends how you define "most parts" and "active outbreak".

Were there 10 new cases diagnosed in the county I live in yesterday? Yes. Am I worried about going about my usual business with a mask, dutiful hand-washing regimen, and avoiding large crowds? Not even slightly.

When you stay 6 feet away from people in the supermarket or the running trail, that's not "Social distancing", it's "Physical distancing".

"Social distancing" is not going out with friends to the movies, or dinner, or to play basketball.

Don't get me started on "stimulus checks."

Another anonymous altered me that there might be a problem with those checks, so I just ran through the IRS web app. My "Payment information is not available." YMMV, but I did file in 2018.

It appears none of the government websites were designed to accommodate a massive spike in activity. One takeaway from this pandemic is that has to change. Big government failed.

If we are to harden ourselves against catastrophe every public facing government interface has to be able to scale orders of magnitude in an instant.

No one in the private sector attempts to go from zero to 100,000,000 users. They know to start small, with an alpha, then beta, then general release. (Some may remember that gmail addresses were by invitation for a long time.)

I've evolved to the opinion that government must do the same, if it wishes the same success. They must explicitly do pilots for fractions of the population, and scale with intention, before going full-blown.

In this case, how would that work? Well, you might have to carve off sections of the population you can easily serve. Issue 10,000 checks to a pilot group first. Then 100,000. Then 100,000,000. And hopefully the cycle times on this could be fast.

But it's much easier to fix problems when you're at the 10,000 user scale.

I used to work with web middleware that did exactly that.

Someone somewhere within government has to begin planning with a "what if" statement.

What if the economy crashed and 3 million people need to apply for unemployment in a few weeks? It is not hard.

Technically, it is small government that failed.

Everyone I have seen complaining about the status of their "future tax liability given to you now courtesy D. Trump" check said they filed in 2018 but hadn't yet for 2019.

I filed in 2019 and already got mine. Guessing there is priority first to those who have most recent information?

Perhaps. I have slacked off with the new deadline.

I also filed in 2019 and have already paid the taxes I owe. No stimulus deposit so far. Website says it does not have my info.

I got a refund so they already had my direct deposit info from 2019. The plot thickens....

otoh
both running and grocery shopping are social as well as physical activities

By definition super spreaders have higher contact numbers and hence are more likely to get Covid now and not in the second wave. This will hopefully reduce the second wave impact.
Additionally, studies show that covid is already 10-15% of pop in hard hit areas which will also reduce second wave.

We know what a sustainable response looks like—it looks like South Korea’s. But we missed our chance during February to have a South Korea style outcome because our leaders were all treating this as a Chinese problem, so now we have to have social distancing to get this down to a manageable level where we can deploy a South Korea-style response.

As to whether social distancing is working, it’s not working well enough. The US cases peaked around 10 days ago but it’s really been a plateau rather than a peak. Compare to Italy, Spain, or Germany, where cases had clearly fallen within 10 days of a peak. It’s quite possible that these countries will be able to reopen sooner than the US and even have a lighter overall outbreak than the US once the course of this pandemic is done.

And if some countries successfully contain the disease while others go for herd immunity, it’s going to be that much harder to return to a normal economy because the countries that contained the disease will have to continually have restrictions and monitoring in place to prevent reinfection—just look at how dire China’s latest economic numbers are even though China contained the disease. Those dire numbers are dire portents for us. If the whole world had acted like South Korea did in February, the economy would be in much better shape.

I think Tyler is showing some pessimism because, while we do need to "deploy a South Korea-style response" we show no sign of doing so, especially on a national scale. Not all states ..

We can’t deploy a South Korean style apparatus until we get numbers down - way down - such that a South Korean strategy is applicable.

@Zaua - "Compare to Italy, Spain, or Germany, where cases had clearly fallen within 10 days of a peak" - no! You make the same mistake I have made. Notice in all these countries, except Iran which seems like fake data, everytime

...every time there's a peak, after about a week there's a spike up. See the John Hopkins site, click country then lower right new cases.

No doubt Iran data is inaccurate, but it seems plausible that Iranian population are self isolating more strictly than are Italians, Spanish, Germans.

We missed the South Korean chance because back in February China and the WHO were still misinforming us.

The were still insisting that the vast majority of spread was from symptomatic patients, we believed them and did not prioritize invasive, expensive tests. We believed them and let the goods needed to man a South Korean style system leave the country after purchase by front companies.

We read from the WHO that the total increased cost burden from Covid would be around $700,000,000. We planned accordingly.

The WHO told us that universal masking was likely to be actively harmful. All the way through March they told us that universal masking was deleterious, even as China was sucking up huge quantities of the global mask supply.

South Korea, Taiwan, and Singapore did well primarily because they ignored the lies of the CCP, restricted ingress, and quickly adopted habits like near universal masking.

I read the recommendations in real time. The folks whose job it is to inform front line providers like me screwed the pooch.

And then of course there is the utter atrocity of China ordering sample destruction, allowing mass gatherings, and fining/disappearing docs who sounded the alarm.

Was it really your prior that the US should depend on the WHO?

Intelligence report warned of coronavirus crisis as early as November: Sources(*)

The actual reason we have intelligence services is so that we don't have to take any foreigner on their word.

* = sorry about the auto-start video ad on that.

"Was it really your prior that the US should depend on the WHO?"

LOL, typical anonymous. Calling the doctor a liar, because he's saying that anonymous doesn't want to hear.

That's not a good reading. I accepted what he said and asked a question about it.

And really, seriously, I would not have expected at any time in my life prior to 2020 I would hear this:

The US had to wait for (insert international organization) before it could act.

It's especially astonishing that we'd hear this from conservatives, am I right?

Sure, the WHO acted weird, but it's an astonishing argument that we needed them. And Trump himself just made a glaring logical error in a tweet. He asked "why didn't the WHO listen to Taiwan?"

Well, why didn't we? When did we cut off our nuts?

Being a doctor doesn't qualify Sure on what the US government knew since he is only relying on what Trump told him.

He is qualified to repeat what Trump said.

Actually no. I am also qualified to speak to what the British NHS was telling their ID folks. If I recall correctly, back in February we also tapped personal channels in Israel, France, and South Africa.

I know what the career civil servants at the CDC told us. I read what the WHO folks wrote in their formal recommendations. We had folks check in with other national health systems.

It was not merely that DC failed to send out accurate information but we also saw failure from Geneva, London, Paris, Pretoria, and Tel Aviv.

Nor was my experience unique. My contacts from MSF report that their own hospitals in their own countries were likewise not told the truth back when we needed it. If anything, I have gotten truthful data sooner than them, though I suspect that is entirely do to having more time before the pandemic broke here. And it is not like they are exactly disinterested parties as several of them had been in Africa fighting Ebola.

When this many doctors on this many continents from this many specialties were misinformed, the problem has to be common to all of them. The most apparent common loci of misinformation were the CCP and everything else they control in China and the WHO.

Trump is a bit player whose entire string of failures is a rounding error compared to what Xi and company caused.

Thank you for your information and background. For a British citizen, you sounded more Trumpian than I would have expected, but that also leaves me questioning your comment yesterday about how Americans follow and believe in Trump, how he is a great communicator, etc. Now I understand how you could say that. You have to be here to disbelieve it.

You misread his comment.

Sure is American.

I am American, but I and a number of my colleagues are part of Medecins Sans Frontieres/Doctors Without Borders. As such we have contacts in every major healthcare system in the world. I have practiced medicine on six continents; in a pinch I can have answers from folks pretty much anywhere on the globe. The place where my contacts are the weakest are the countries where the health systems are robust and unlikely to need help from MSF, but also that send fewer docs to crisis areas. This does give me a blind spot for East Asia. But Europe and the Anglosphere? If they knew something terribly different than me, it would show up in my inbox.

When we got concerned about Covid back in January, we contacted our friends and colleagues from MSF who are based elsewhere. We checked in with MSF itself. Likewise, a number of my colleagues trained outside of the US and they contacted folks back home.

The story one colleague had from her old teachers back in the UK matched the one we were hearing in the US regarding things like asymptomatic spread. Likewise one Jewish colleague heard similar things coming out of Israel and another from South Africa was getting the same story. Somewhere around a third or so of general hospitalists docs in the US are foreign born. When something this big is breaking we will hear what other countries are saying.

And it all matched. Italy clearly did not believe that their healthcare professionals needed universal precautions. Nor did Spain. Or France. They all paid for this in dead physicians and nosocomial spread.

How did so many people in so may health systems get this all wrong? It cannot be Trump, he can do piss all to affect the Italian health system if he tried. And even if you think he has magical massive leverage with the Italians and other Europeans, this also caught Iran with their pants down.

The common place where we all got our information was out of China. In retrospect, sure we should have assumed they were worthless and gone straight to Taiwan and South Korea, but we all figured that China had learned from SARS not put face over health.

What I know, for a fact, was that back in February we got the most current recommendations from a number of nations, NGOs, and of course the WHO. They were ALL wrong. We were wrong not check in more thoroughly with the more honest administrations near China, but the mistake was common.

So, what you are saying is that,
you had information in January,
you and otherswere concerned,
there was asymptomatic spread which was confirmed by others.

Why was Navarro concerned in January and what information did he have that you didn't.

Is this a massive intelligence fail that should be looked into?

Or, might it be that someone decided it was worth the risk to take the herd immunity approach.

I do not assume ignorance, nor do I assume that the US relies solely on the Chinese Communist Party for its information. Or, at least, I hope not.

PS. Thanks for indicating you are an American. I was going back and looking at the time stamps for your comments to figure out what time you responded from England.

I work irregular hours regardless.

I do not know what everyone in the US government knew when. I know what I was told when I asked fair questions of the experts who should have known this. More importantly what I asked should have been known in China last year. The fact that China covered this up is several orders of magnitude more important than any failure of the Trump administration (of which there are many).

You have to understand, the risks China was running here are comparable to small nuclear conflict. So yeah, we assumed that China was not that reckless and dangerous. Evil doesn't mean stupid or careless, but this has shown a much more worrying side of the CCP than their usual repression and thuggery.

Maybe Xi is just like another politician: Hide it until it gets out of hand and you can't hide it anymore.

But, that doesn't excuse us, if we have a politician that will expose more people to death by opening too quickly so the stock market gets a bounce. Or attacking governors for being careful and following their public health advisors. Or, supporting the Liberate movement with Tweets. We do not live in a dictatorship, and criticism of elected officials does provide the information which may change course.

Our system, at least since 2012, was built on the assumption that we would be given accurate data by the originating country or that we would have access if they were not able to do so.

This is how extremely bright people light Dr. Fauci got it so terribly wrong back in the early days. Nobody thought the Chinese would be willing to do something that is the equivalent of playing Russian roulette with a couple of thermonuclear bombs just to save face.

The public health advisers have had a pretty lousy track record. My state's told us not to have general masking, that there was not going to be significant asymptomatic spread, and that it was unlikely that we would all face a large PPE burden at the same time. They made these recommendations because they were, again, following bad data.

Is Trump tweeting unhelpful? Sure. Is it going to amount to more than a rounding error? No.

And frankly the specifics of the lockdowns are asinine in some cases. Lottery tickets are essential items that can be purchased while patio furniture is not? Going to church and staying in your car is grounds for government advisement and tracking but standing in a crowded line to apply for unemployment is not? We should be figuring out what activities are dangerous, full stop. We should be figuring out what precautions make activities safe, full stop. And then we should be letting adults do things safely and fining them if they don't.

You can fault Trump for far more dire things than his kabuki about when the economy opens or torching highly unscientific ad hoc lockdown orders. Those, especially at this late date, are drops in an ocean.

Xi is not another politician. He is a totalitarian thug. There was evidence of human-to-human spread on December 6 in Wuhan. The CCP quarantined a huge area to limit spread within China but did nothing to stop air travel OUT OF CHINA until other countries started doing it themselves. The WHO, led by a guy from the Chinese client-state of Ethiopia, disgraced itself. Our NIH and all its baby agencies, addicted to process and paperwork, dragged their heels every freaking step of the way on minimizing the damage. The hell with all of them.

There is more at stake here, much much more, than a $2 trillion addition to the trillion-dollar federal deficits we were running in times of full employment and robust GDP growth. Our grandchildren will bear this burden for the rest of their lives.

I didn't vote for Trump, but I'm tired of the lazy assumption that things would be different now if the election had gone the other way in 2016. Everything would just the same. If your preferred candidate wins in November, there will be less gasbaggery, maybe, but nothing substantial will change.

THAT is the problem.

\

Sure,

I guess you are also saying that US and foreign intelligence agencies had a massive fail as well.

Do you think that should be looked into?

Yes. Later.

I have held that pretty much sense the end of the GWB's administration we have let our commitment to infectious disease problems wane precipitously. Whatever its faults, his administration took the threat of emerging infectious disease and bioweapons seriously.

My military contacts are not what they once were, but they do suggest that we were blind and not looking where we should have better covert intelligence.

"That's not a good reading. "

Bullshit! You don't ask somebody ""Was it really your prior .." unless you are insinuating they are pushing an agenda.

If you just wanted to ask a question the appropriate question would have been a simple: "Do you think the US should have been following WHO advice?"

It's not like Sure could have unilaterally over ruled the CDC which was following WHO recommendations.

Sure has explained himself. He thinks that the international community of public health officials were slow off the stick.

But as others have noted, that doesn't really explain why some countries were able to see through the .. groupthink?

I don't think anyone where is going to suggest that the WHO was nefarious. They were just trying what Sure suggested as regards his own patients. They were workin' China to get what they thought was the best outcome. Though perhaps we can say in retrospect that they took their cultural sensitivity too far.

BUT we should definitely not lose track of the fact that the government of the United States should have had at least two sources of information here. Including both the public information from public health services, and the analysis of our spies.

We should have incorporated both in our national security planning.

And very obviously what we can generously call a "reorganization" of pandemic preparation within the national security apparatus was not too successful.

There is plenty of blame to spread around. This was happening in New Orleans, around mid-March. "His hospital had not prepared for this volume before the virus first appeared. One physician had tried to raise alarms, asking about negative pressure rooms and ventilators. Most staff concluded that he was overreacting. “They thought the media was overhyping it,” the respiratory therapist told me. “In retrospect, he was right to be concerned.”

One doctor seemed to be clued in, but he clearly was not following the guidance provided by the hospital administration, WHO, the CDC and FDA, and he had to deal with the ridicule of other medical staff. However, it is not possible to retrospectively blame the media for not letting people know what was already happening in Italy.

You’re right information flows are multi-vector and weighted. Logically, then, when one information flow has been determined less reliably, we should in turn discount the investment into that flow.

Or certainly make a conscious effort to glean wheat from chaff.

"...quickly adopted habits like near universal masking."

It wasn't near universal. Percent of those who wore face masks in February:
Hong Kong......90%
South Korea....70%
Japan................68%
Singapore........23%
Taiwan...............?

China was at 85% using a face mask so Taiwan was probably about the same.

One of my colleagues told him that Taiwan was around 90%, but that may have been just Taipei.

Singapore's masks numbers look very low. Back in January they were issuing 4 masks per household from the government.

Back in January we were still be told that masks were of limited utility unless you were sick or treating sick people. The WHO specifically recommended against it.

And this is not unreasonable. I have read the literature and such crappy experiments as exist suggested limited benefit with one study showing active harm. Maybe masks, particularly if infrequently changed and not restrictive enough might provide you with more chances to inhale viral particles. Maybe masks might become fomite vectors as people do not wash their hands after removing them.

The answers to those questions would best be found by the country treating the infection the longest. The one with samples cooking in a hot lab and measuring actual performance of various filters and tracking cases of nosocomial spread.

Instead we had China. Where they destroyed samples, punished docs who discussed nosocomial spread, and then lied to the world.

Again I stand by my comments. The more we listened to the WHO. The less we distrusted Xi and his cronies. The more we followed the treaties … the more we failed.

Maybe we should have assumed that the WHO is incompetent at its primary job. We definitely should have assumed that China is a dangerous autocracy that will kill people to save the regime's face. Live and learn. But, as with fraud and confidence schemes culpability lies with the purveyors of falsehoods - Xi and the CCP with a side of incompetence from the WHO.

Thanks for explaining your background.
It's clear that China didn't come clean immediately.
But China did eventually announce asymptomatic transmission and transmission of the virus without contact in interior spaces. And the West took seemingly forever to act on these warnings when they arrived. The ski town in Tirol that stayed open for a week after Iceland informed them that they were exporting the virus. More examples in the US than I care to think about.
Somehow China and Europe and America all needed to learn this for themselves. Just because China was first to deny (but also first to acknowledge) the seriousness of the virus, doesn't put China at fault for all subsequent denial.

This is an exponential curve. Mistakes made early are exponentially more important than mistakes made late.

To put this in perspective, if China had been not quite as bad and announced this to the world in full what its own clinicians suspected back on January 7th, the we would currently be facing maybe 9% of what we are currently facing.

If Trump acted perfectly. Had an immediate screen going everywhere with a stream lined clinical trial process with vents being made round the clock and giant stockpiles of PPE and magically eliminated 100% of US cases … we would still have over 76% of the problem running free in the world.

Note, I am not talking about China actually being a responsible health system with effective reporting (that would mean December was the jump month); just that once Xi was personally briefed and the regime began to change tacts he came clean. 90% of the problem goes away under that scenario. Trump is more on the ball with his PPE strategy? Likely not going to move the needle more than a percent or two. And on it goes.

The world does not revolve around Mr. Trump as much he and his detractors wish. The real fault was in the early days. It lies with China. And even if we could have overcome their lying and obfuscation, that takes time and early time is worth exponentially more than later time.

And I am not speaking in hypotheticals. I asked, professionally, and we got counter productive answers. There is not a lot more that anyone can do when you burn the most effective response time pissing around with image control.

Sure, you can't blame Italy on the POTUS. But there was plenty of denial in Italy, and there is plenty of denial in Brazil. The US CDC surely ranks up there with anyone in terms of incompetent response.
When you blame China for being the first to screw up you're just blaming them for being first, which is not unfair but a little late now.

No, I blame them for suppressing the appropriate response, lying about, buying up PPE while lying, and not coming clean with their data.

This not the first epidemic in the world. When an epidemic breaks out the important things are to recognize it. In any sane society, docs who suspect one call somebody, maybe even the press, and say "I'm worried". The officials say "You might be totally overacting, but that's okay we don't want to miss it". And then we bend over backwards to make sure that any doc's suspicions are not overlooked.

I mean seriously, the CDC has a 24-7 phone line for possible smallpox cases. We have not had any cases in my lifetime. Yet when I called saying "Hi I'm 99% sure this is chicken pox, but here are the atypical clinical findings (later found to be due to an underlying syndromic condition) that make me call just to be safe." I was not reprimanded. I was thanked and dealt with very professionally and then they followed up later to be sure.

China instructed the lab to burn the samples.

I blame the US for listening to China. I blame the US for having bureaucrats who could not adapt to the fact that China lied in a timely fashion.

I blame China for punishing docs who were doing the right thing, burning the samples, and then lying to us when their own physicians at least suspected a different set of facts.

We were, at most, incompetent. They were, at least, willfully risky with the most dangerous situation in the last 10 years.

Liberia, Guinea, and Sierra Leone were more responsible with their epidemic than China was.

It's worth pulling this quote:

"Analysts concluded it could be a cataclysmic event," one of the sources said of the NCMI’s report. "It was then briefed multiple times to" the Defense Intelligence Agency, the Pentagon’s Joint Staff and the White House. Wednesday night, the Pentagon issued a statement denying the "product/assessment" existed.

Do you posit that the Korean government is capable of reading minds? Failing that, how do you posit that they were able to respond appropriately if the fault lies with WHO, and both countries had their first infections on the same dates?

I posit two things:
1. South Korea has more experience with Chinese lies (e.g. more direct experience with such lies back with SARS) and has a better gut sense of how far the CCP will go to save face (e.g. killing a million people). In these sorts of situations, errors can compound and if everyone aggregating data is 10% less suspicious of the CCP than they should be, you can easily get an order of magnitude error on overall severity. When dealing with exponential growth curves small improvements in accuracy can have massively disproportionate improvements in outcome.
2. South Korea got lucky. Their biggest initial outbreak was in a well defined religious group. Said group, which has long been deemed a cult by much of South Korean society, buckled and began cooperating heavily. This made it vastly easier to track a bunch of cases early on and to derive estimates about things like asymptomatic spread. Being able to easily track one transmission chain through a centralized organization (the religious hierarchy) is about as good as it gets. This also proved the value of tracing and improved the willingness of society to do things that the US frowns upon (e.g. using a flu surveillance study to test for Covid). Having a profound, early example where the system works makes it a lot easier to force bureaucracy to adapt to the current circumstances rather than chase phantom potential privacy harms.

I'm not sure how either of those scenarios leaves the WHO as the culprit in our system of governance. I guess unless you think our representatives should just take the WHO at their word and not bother further? That our representatives shouldn't have asked South Korea what they were doing in preparation for this? Doesn't that seem kind of absurd, given all the facts you present about South Korea. If we know they have experience responding to diseases like this coming from China... why wouldn't we at least dialogue with them about a response? If South Korea can track... why don't we track like South Korea? If tracking is dependent upon testing, why did we disregard South Korea's immediate response in favor of closing air travel to... China?

Even if everything you said is true, I do not understand how that obviates the responsibility of our representatives to adequately govern.

In a nutshell?

South Korea is a small fry typically. They have a small health system and not as well represented in international forums as other health systems. And their claims were at odds with everything come out of China and the WHO.

I have a day job, so do a lot of other people. When we face two conflicting sets of data we cannot just immediately guess which is better. Maybe South Korea was being paranoid, after it is well known in medicine that docs who miss something and get bitten (e.g. SARS) are more likely to overdiagnose it later. Maybe China was blithely risking millions of lives to save face.

Determining who is telling the truth takes time. China had a lot more data. China had a lot more resources. China had had a lot more time. Frankly the only reason to trust the ROK over the CCP here is if you believe that the CCP is basically evil and willing to risk millions dying just to save face.

I'm a China hawk. I believe the CCP is an evil regime that runs mass concentration camps, harvests the organs of prisoners, and seeks to not only control the daily lives and opinions of its own citizens but seeks to undermine basic freedom throughout the world. I still did not think that Xi and company were either so incompetent or so evil that they would sit on R of 4 virus with a 1% CFR.

The reason we do not track like South Korea is many fold. For starters, South Korea has a higher relative amount of domestic production of required inputs. South Korea also sold less essential equipment to Chinese front companies back when the CCP was lying to the world and using its intelligence organs to raid global markets on the down low. South Korea does not have the IRB nonsense that cripples quick action. South Korea does not have a political system where when one side says something is an emergency the other shouts "racist" or "hoax".

At the end the day, debates about testing, or lack thereof, are talking about the last 4% of causality or worse. Xi and his regime are the first, second, and third authors of our current misery.

How can I take you genuinely when you poo poo this away as not being your day job? Who would suggest something so absurd? My point is, there are people who have (probably more like had, from the reports I read) the job of tracking this kind of data and making these kinds of decisions. Or at least, providing data to the people who do make decisions. As far as I can tell, that's more or less happened and yet, here we are, with about the worst response imaginable.

It also seems entirely disingenuous to equivocate the "racism" and "hoaxism" going on when the president of the United States is suggesting these states need to be liberated. As if Nancy Pelosi bein incorrect obviates all other decision-maker's responsibility to govern well.

I am a clinician and an administrator. I can do due diligence, but by the time I due a thorough vetting of competing claims it is too late for me to act. People like me are too busy actually treating patients to look into the claims of places like China and see if they hold water.

We know this so we fund organizations and staff them with people who are supposed to do this. Two of the big ones are the WHO and the CDC. One of their explicit responsibilities is to do these sorts of evaluations so people like me, do not have to do them several hundred times for each system in the country.

And lest we forget when China signed on to the WHO treaty they said, "The health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and States. "

They did not give the "fullest cooperation". They actively suppressed cooperation.

So China failed to meet their most basic treaty obligations. The WHO, for reasons not known to me, sidelined Taiwan and South Korea. The WHO then told professional that they had vetted the data and things were exactly as the CCP said with some small amount of ass covering.

This was a failure. The WHO either trusted China or cared more about politics (like their atrocious response on Taiwan).

Frankly the states do need to be liberated. Right now we have ad hoc orders that make no medical sense. Why are lottery tickets essential goods that can be sold? Why aren't seeds? Why are we closing parks were people are maintaining adequate distance but ignoring block parties with hundreds in attendance? Why are letting people wait in line for takeout, but get all worked about drive-in church?

Yeah, I get they had to do something and better to be over cautious than not. But these measures need popular buy in and we should be condemning things like Whitmer's silliness about lottery tickets.

And eventually all the orders in the world are going to be meaningless if the population does not follow them. Conversely removing all the rules will do nothing if the population wants to keep following them. At the end of the day, people will have responsible behavior provided they have accurate information and time to adjust. I worry far more about delaying the loosening of the strictures and attending general noncompliance than I do with about slackening off too quickly. The former is a non-stop ride to uncontrolled spread and maximal death tolls. The latter is a deadly ride to retightening of controls.

Once again, such a completely disingenuous response inserting your own role into something it has nothing to do with. No one has suggested it should be your duty to make these evaluations. As I said before, this is the job of people who work for those in Washington, which isn't you. So why do you keep inserting yourself into it as if it has anything to do with the question I asked. I'm utterly perplexed!
For example. there at least used to be a CDC czar in China. You'd think that would be the person to compare our take on China's and the WHO. So, this is something that is entirely possible for our gov't to do. That's why blaming it on the WHO is pretty absurd. All of our politicians have failed us here.

As to the rest of your post, I'm genuinely confused. States need to be liberated from themselves? One state does one thing so another state doesn't do another thing, so people might get confused, so we just shouldn't bother at all? This is such a lame discussion. Tell me something that makes sense, please

Actually the folks who are most responsible for this work in Atlanta and Geneva. Part of the reason we pay almost $900 million dollars a year to them. Our government opted to meet part of its duty to do this sort of evaluation by paying the WHO to do it.

As far as what happened in Atlanta, I do not know. I know that China did not give Atlanta direct access to data. I know that China rebuffed offers to send experts from Atlanta to Wuhan (as we had done for other outbreaks, like Ebola). And even having a "Czar" in China is not going to do much absent cooperation from China.

At the end of the day what we needed was for China to let its physicians talk freely and candidly with the CDC, WHO, and everyone else. When they failed to do that we needed the WHO tell us that China was not meeting its treaty obligations. They failed to do that. We needed the CDC to tell us that the WHO appeared to be politicking and their judgements are not trustworthy.

These were all failures, but the culpability lies overwhelming with China where they fined doctors for speaking out, destroyed samples, and lied for weeks.

I can only fault folks so far. Normally even autocracies are unwilling to play Russian roulette with thermonuclear weapons. Yet that is exactly what the CCP did here. Deterrence theory, most schools of international relations, etc. rely on the other guy not being that risk tolerant or abjectly crazy. This was literally more risky than anything the USSR did in its last 30 years. So I can understand to some degree how people could be in disbelief that the CCP could be so shockingly dangerous.

What do you mean? South Korea hewed closer to WHO recommendations than we did. The WHO was recommending monitoring as early as mid-January but no restrictions on travel. South Korea started monitoring and did not restrict travel from China (it later restricted travel but only from countries that were restricting travel for South Koreans). There were protests against the South Korean government at the time, but when its approach turned out to be correct, the government was reelected in a landslide.

The US deviated from the WHO recommendations by banning travel but not monitoring. We all know the results now.

And the question of how much transmission is attributable to symptomatic vs. asyptomatic carriers seems like it's still up in the air.

Taiwan actively distrusts the WHO for obvious reasons. Hence why they acted in December!

The real answer here is that there were multiple failure modes and all should be held to account. WHO cares whose ox is being gored.

But that doesn’t satisfy the need to turn this into a Culture War feces throwing contest.

What do you mean Taiwan acted in December? Read the Taiwan CDC press releases from January: https://www.cdc.gov.tw/En. Taiwan was echoing the WHO and basically saying the same things the WHO was saying.

There might have been specific people in Taiwan sounding the alarm in December, but these public press releases show that the Taiwanese government certainly was not acting in December and was not publicly disagreeing with the WHO.

Taiwan began screening flights from Wuhan on 12/31, suspecting that the CCP was lying. Clearly Taiwan had intel that Wuhan was in a much different place than the official story coming out of Beijing.

Taiwan clearly suspected human to human transmission even while the WHO was claiming zero human to human transmission:

12/31: All flights from Wuhan screened for disease

1/14 WHO: no human to human transmission.

1/20 Taiwan: activates CECC, bans exports of masks, issues mask guidance

There's a reason there have been 6 total deaths in Taiwan. Not trusting Beijing or the WHO is the main one.

South Korea banned entry for foreigners who had visited Hubei on 04 FEB (announced the previous weekend) and "urged" voluntary quarantine of South Koreans who just visited (and if memory serves paid some cash to incentivize people to do this). South Korea tested asymptomatic individuals back when the WHO believed that to be futile. South Korea had heavy public masking in place back when the WHO was actively discouraging it.

I could go on, but suffice it to say, nope. Back when the UN was saying that travel bans were counterproductive South Korea put one in place targeting the most dangerous part of China.

As far as transmission attribution. Oh please. I have had over a dozen patients who are all either the worst historians or who got this through asymptomatic spread. We have maternity nurse who caught it with no known community exposure, but with exposure to an asymptomatic patient (no temp, normal pulse ox, no tachypnea) who later tested positive.

Within a week of treating Covid patients, and I am not in a major outbreak zone, I would lay my marker down on asymptomatic spread being at least a quarter of all infection. Any physician with any basic competency for infectious diseases should have been having the some gut response. Maybe we are all wrong and it merely looks that way while you are treating patients … but such appearances were also noticeably absent from the official narrative back in January and February.

Of course what do know is that docs who relayed at least this sort of gut check and suspicion were harassed, fined, and perhaps disappeared by CCP.

Chinese doctors are not idiots. They saw what I did. They suspected the same damn thing as me and did so likely in the same timeframe. It just seems that the CCP decided that them raising any sort of alarm was a public order offense that needed to be squelched to preserve the regimes face rather than warn folks like me. The CCP decided that making the regime look good was worth risking millions of lives, eff em.

Well China already banned all travel out of Hubei on January 23rd, so other countries also banning travel from Hubei doesn’t seem to do much. However, whatever justification there was for banning travel from Wuhan, there was none for banning travel from the entire country of China, most of which had few to no infections, and countries like Italy and the US are now paying the price for implementing an ineffective travel ban instead of testing and tracing.

Regarding asymptomatic transmission, I’ve seen a ton of different estimates regarding how prevalent it is. According to this WHO report from April, there has been some pre-symptomatic transmission but that true asymptomatic transmission is possible but there are no documented cases of it: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf?sfvrsn=5ae25bc7_2

I don’t think China or the WHO was lying about the extent of asymptomatic transmission in January when that is still disputed today. And it’s unclear how a virus being asymptomatically transmitted or not would make the Chinese government look better or worse. Seems instead they were being reasonably cautious before confirming possible routes of transmission, which can be sensible because rumors of unconfirmed routes of transmission have caused horrible things like people killing their cats because cats were a possible source of transmission in link #1. And even if asymptomatic transmission was as high as 25% like you say, that still means the vast majority of transmission was symptomatic and we could have taken care to test those.

They fined doctors for saying what any competent doctor would say.

Not said "well we disagree" or "well maybe that's a possibility but we want to be cautious". They bloody fined them, made them confess to minor crimes, and generally shut down the entire discussion.

And lest we forget they ordered the destruction of samples. You can be as cautious as you like, but you do not stop sequencing (as was happening in December) and burn the samples out of "caution".

You do all that to suppress information. If China were truly being responsible, they would have welcomed dissenting opinions, let their docs confer with each other and foreign experts without penalty, and let the science proceed.

They did none of those things. So no, they suppressed everything and thousands died as a result.

China made some missteps, but they also disclosed the disease on December 31 and shared the genome by January 9 so it’s not like they were completely covering it up: https://www.axios.com/timeline-the-early-days-of-chinas-coronavirus-outbreak-and-cover-up-ee65211a-afb6-4641-97b8-353718a5faab.html. If China had been completely forthcoming, it would have made a difference of a few days at most. Moreover, many of the doctors who were silenced in fact got it wrong—Li Wenliang was suppressed for reporting that SARS had returned, which was wrong. Of course China shouldn’t have suppressed Li, but what difference could it have possibly made if the wrong information that SARS had returned had been made public? If anything, people would have become even more complacent because the original SARS was not as contagious and was quickly contained.

By contrast the US government delayed action and suppressed private testing for over a month after the first case. It’s hard for me to fault the Chinese government for delays measured in days when ours had delays of over a month. In fact I wouldn’t be surprised if people in China were as angry at the US government because its failure to control the virus early like South Korea will mean a constant threat of reinfection and economic damage from lost trade and travel in China.

Dr Li was punished for saying a SARS like illness was circulating in Wuhan.

Come on dude.

It takes 3 days to sequence a genome. China had samples before Christmas. This isn't the 2000s or even the 2010s. We can move a damn site quicker than 10 bloody days. So yes, China sat on things such that the genome release was released two doubling periods late.

And that is if we start the clock on 31 DEC, which would already be far later than China's own doctors called for back when the CCP was busy fining them.

And a few days is literally thousands of lives at this point. In the early phase, Covid doubles every 3 to 4 days. Burning a week is massive. You literally make the problem four times worse.

That means four times the cost to fight. That means four times the dead.

And get off with bootlicking of the CCP. Li Wenliang was far from the only person. Ai Fen for instance was reprimanded for saying that a "SARS-like virus" was breaking out. This was, of course, precisely correct and true. Now the good doctor is mysteriously silent with only clumsy updates to her social media.

Nor were these the only cases. China told physicians to stop doing their jobs. To not let the public know. And unlike with the US there is no safety concern here. Because what happened when the virus was belatedly acknowledged? No rioting. No mass disturbance. Just people getting on with life.

And as far as the US's delayed tests. Well when you listened to Chinese sources regarding spread data (i.e. literally 95% of the data present for that month), it changes the tradeoffs for sensitivity, specificity, and capacity that you want in a test. If, as China was positing, over 90% of spread was coming from symptomatic cases then you can use temperature and symptomology as your primary screen. This means you want a test with better performance than the WHO protocol and you want more validation rather than quicker tests.

So yeah, our testing delay was caused in large part because China lied.

And this is how it goes in an epidemic. By nature, mistakes made earlier in the time course are more costly than the same mistake later. China pissing around for a week with the genome is literally more deleterious to the response curve than an entire month of the Trump administration dithering. And it is not even close.

Worse, when you lie and suppress at the start, resources get activated and plans are made that are counterproductive. It is 10 times harder to change course than to get started correctly with accurate data.

We get, the CCP could gun down millions in cold blood and you would equivocate about US police brutality.

China was literally willing to risk the death of one percent of humanity rather than make the CCP look bad. Everything everyone else has done is barely a rounding error.

Your anger about the early handling in China is 100% legit. I'm not sure it excuses the US.
I have a question for you: the Federal government has stated that it is not in the business of delivering PPE to states, while simultaneously intercepting N95 shipments to hospitals. Is this business as usual for the countries where MSF works? At what point does MSF pull its people out when the local government makes them work under unsafe conditions?

In reference to "…But then you undertake a second-order calculation about how the greater danger spurred by the forthcoming decline in social distancing also might spur innovation…"
I doubt this very much, the young are responsable for most innovation and they don't see this as a threat to them. Instead the response to the coronavirus has been a massive emasculation of the young, they have little of the risk of Covid but bear the brunt of social and economic consequences of "social distancing." Let's not forget that the response to coronavirus has also undercut small business and self-employment, two nursuries of innovation. Coronavirus response is the exclamation point of a long trend that the world is older, more cautious, and less concerned with youth and the future.

Just the most brazen example of "sell the kids' futures to prop up the boomers" but by no means the only one. We would be in a much better position if we had encased the elderly in bubble wrap and let everyone else get on with life.

+1

All that we're doing would make so much sense to me, if it was children and the young generally, that the virus was taking. So I am that kind of weirdo, I guess.

Also the kind that dislikes mask-wearing intensely - but everyone else seems to be fine with it, cool, comfortable, and collected. I can't stand the feeling of exhaling in a mask, it turns out. But I know the only bigger jerk than the people shaming others for not wearing a mask, or getting online to complain about kids playing basketball, is the person who pointedly refuses to wear a mask to annoy everybody (and now it's required here anyway). So I have rigged up a sort of odd get-up that still allows me to breathe, more Little Edie than CDC.

I guess I fail your test. I do think " it is splendid and noble how we all can come together and sacrifice for a common endeavor!" at the same time as I think all of those other questions you raised as well. It doesn't work very well, but it works a heck of a lot better than not doing it. But maybe it's because I'm not an economist, but we have to at least try

Except that as an Australian, right now, it appears that we might win this thing outright.

Early on, I complained that people were using a metric without a denominator - just deaths or reserve ICU capacity, not (deaths) over (social + economic costs). But now success is being measured just in number of infections (low being good) which is certainly no better than second best, and at worst counterproductive in the long run. Managing for low infections is almost certainly not optimising for premature deaths/cost.

Such hubris for someone in the southern hemisphere. The test will come for you in winter.

>I do think " it is splendid and noble how we all can come together and sacrifice for a common endeavor!"

Everybody does.

Tyler's post is not really about social distancing. His biggest fear is that, come November, people will look back at this time and see it as "when the nation came together." That would be an absolute nightmare for the Dems -- and frankly, the most likely outcome.

If someone told me “Social Distancing is Working so Well!” I would assume they had moderate expectations. That is, they are satisfied that SD did bend the curve, and COVID-19 didn't blast right through it.

But obviously that's not the end of the story. We aren't out of the woods yet.

And my personal observation is that even in relatively hot areas people think they've got it handled now, as they take non-recommended risks.

It might be true that in the immediate future, more danger than opportunity waits.

Physical distancing is not social distancing.

I don't need to hug you, shake your hand, or slap your back to interact with you.

Not only does this electronic comment prove that--because you are reading it and understand it (maybe)--this is just one form of communication and interaction.

I've zoomed all over the place,
I've skyped from here to there,
I've hanged out with people,
I've even been in your face with FaceTime.

Don't have to travel to a conference to attend it;
Can zoom in experts to a group conference without having to pay airfare or hotel accommodations and some do it for free;
Can zoom with old college friends whom I always said I would visit, but never did, and now have an excuse for a 40 minute visit than a dreaded all day event;
But,
It is hard to visit old relatives the same way because they are in a nursing home and have trouble even operating a phone.

As for my kids,
They call more often,
Thinking they are immortal,
And
I am not.

@Zaua: "We know what a sustainable response looks like—it looks like South Korea’s."

Nope -- we now have the data showing that South Korea's Covid-19 spread peaked 2 weeks before that nation's social distancing rules took hold. The infection waas already in decline without social distancing.

Why? That seems to happen, and there doesn't seem to be evidence of herd immunity. It flares up and fizzles out. The assumption is that it has spread to large numbers without symptoms, but the evidence isn't apparent.

These things mutate to change from the animal infection to a human to human spreading virus. What happens to the virus over time? Washington State had some data on the changes over time, but I haven't heard much about it.

Do these things mutate over time and become less virulent? Or more virulent?

Something happened over the weekend. Traffic is increasing. Saw a family shopping, three small kids. Snippets of conversation overheard indicated necessity. I suspect we will see an increase in new cases, in a short while as the new normal takes hold.

Residents started social distancing before government rules were enacted.

Yes, because South Korea was doing an excellent job of early testing, contact tracing, and informing the public of things like where sick people had been, thus making extreme social distancing unnecessary.

A better psychometric test would be to ask how someone can write a blog post defending hoarding and black market price gouging of medical supplies during a pandemic and a month later writes another titled when will the riots start. You would think such a person could connect the two events.

Except they are not related

Except that they are. I don’t expect an MR commenter to understand but I would expect an economist that studies human behavior as a profession would be able to make the connection. Especially one that has traveled the world and examined the relationships between people and institutions across environments. And especially one that shares a blog with someone that has begun advocating State Capacity Libertarianism.

@Bill: "Physical distancing is not social distancing."

well, Bill, a host of tyrannical state governors and petty local officials have defined social distancing much different than you and enforced it by threats of jail time.

In your mind, all government is tyranny.
All persons employed by the government are petty,
All social distancing is enforced by jail time.

Take your temperature.

You may be having a fever and suffering delusions.

Nonsense. One can be a staunch centre right social democrat, as I am, and still be appalled by governmental and administrative overreaction in certain places.

Marijuana stores are essential services but millions of hectares of state parks are closed to the public?

Social distancing
For an extrovert is
Hell,
And
For an
Introvert or autistic
Isn't noticed.

I'm not sure about that. An extrovert during social distancing will pick up the phone and call someone or go online. An introvert is even more isolated because they don't have forced interactions.
Here's one viewpoint:
https://www.futurity.org/introverts-and-social-distancing-2319522/

Thanks Ted. I do have poetic license.
However, the way I read the article is that extroverts are more adaptable in seeking out additional ways to communicate (phone v. in person), and that both introverts and extroverts need the fuel of social interaction to be happy. "While it’s true that introverts may be more accustomed to—and comfortable with—spending time alone, both introverts and extroverts need human interaction for their health and well-being, says Matthias Mehl, a professor and director of the Naturalistic Observation of Social Interaction Laboratory in the psychology department at the University of Arizona." I didn't pick up the language on forced interaction. Perhaps you can post it below.

The "forced interaction" isn't from this piece. It's the basis for exposure therapy of people with serious social anxiety. Of course, social anxiety is a side effect of society, in some ways. Asian and Scandinavian cultures seem to favor extroverts less.

Thanks.
That explains why, I, as an introvert, have been happy.
The only anxiety I feel
Is from
Some of the
Comments on this site.

Same here. The most stressful part of this experience has been reading comments on news articles on mainstream outlets where people are literally advocating genocide and war on China. Of course, it’s good for these comments to be out in the open, but it’s still terrifying that those are the kinds of people who are going to influencing government policy here. It makes me feel like COVID is the least of the world’s worries right now, and it may be better for this pandemic to keep the attention of the world’s governments a bit longer until people can calm down.

Tyler, you forgot a category of people: Those of us who aren't smart enough to feel comfortable holding any sort of strong opinion on this. We are legion!

Alternatively, if you hear “social distancing is working so well!” and immediately feel a deep sense of foreboding, and begin to calculate whether good short-term results are correlated with better or worse long-term results.

There aren't any long term results to evaluate yet; the virus has only been around for four months. What really is the value of any of these correlations you're supposedly calculating? Lame.

Brazil is testing a medicinenwith 94% efficiency in cell cultures.

I'm all ears... is it ivermectin?

Covid 19 at GMU Law School: https://www.washingtonpost.com/local/coronavirus-covid-19-recovery-francis-wilson-virginia-dc/2020/04/16/0bb55974-7858-11ea-a130-df573469f094_story.html The sense of foreboding never leaves. If I get it at least the sense of foreboding will end, if I survive it or not. In my first comment to this post, I linked an article in The Atlantic that explains why the incidence may be significantly understated. In response to a prior blog post by Cowen in which he linked to a long series of graphs, I observed that the incidence seems to be overestimated on the way up to the peak and underestimated on the way down from the peak. It reminded me of what Scott Sumner often advises: don't reason from a price change.

What if my reaction was to take out the so and the exclamation mark?

You have a bright future as an editor.

Tyler,

You are overthinking this. We can succeed with relatively simple procedures that have high ROI. What would an economist do?

Social distancing has worked better than most people think. Look at fever data at healthweather.us. Fevers above 100.0 degrees F fell from 5.11% of people on March 16 to 0.05% on April 15.

R0 was about 2 before social distancing. We only need to drop R below 1, not drive it to zero.

I suggest that we can drive R below 1 and reopen our economy with rules that are not too terrible or costly.
1) No handshakes.
2) Stay 6 feet away from most people most of the time.
3) Wear a mask or cloth cover over your mouth and nose in public. I see that 70% of people in Colorado already do this.
4) Measure temperatures of employees and send people home if they are over 100.4 degrees F.

This list may be enough. We don’t need perfection. We just need R below 1 for a year while we work on treatments and a vaccine.

So let’s do some simple distancing and reopen our economy ASAP.

Everyone wants test and trace but it is very costly. Temperature measurements have far higher ROI.

We don’t need to abolish freedom. It’s OK if some people break the rules and get dirty looks because we don’t need perfection.

I would still test, but everything else I would agree with. Probably take off the table large gatherings >10 (which is what a infectious disease doctor was doing before the announcement), probably restrictions on restaurant and bar spacing inside.

People will still be scared and will not mix, unless they are high school or college age. People will not do frivolous shopping as recreation if they perceive it as a risk.

I don't know what the buzzword "Open the economy" means. It seems to be becoming a political buzzword. Employers, for example, don't want employees attending the funerals of their employees. Restaurant or bar owners don't want to be tagged via an app as the place of infection. So, Open Up might mean Open Slowly, Open with Caution, or Open with Restrictions.

This is a good list. May I also add that anyone who can work from home continues to do so. Also anyone that is over 50 with any health issues should continue to self isolate. There is a risk to other segments of the population, but as the recent UK data showed, 92% of deaths are over sixties with bad health. Surely that segment of the population should find it in their interests to isolate themselves as much as possible?

This is exactly what I was advocating a month ago.

And no freaking kissy-face cheek kissing. That's for you, France!

Dave C wins the thread for best answer. I also agree with the other commenter additions. I would add zero mass transit, no congregating at break or lunch, fans or open windows to pull out micro-particles, and all group meetings need to be virtual or outdoors.

Enforcing smart social distancing is likely able to keep this virus' R below 1 without stay at home orders.

Unemployed people who lost their job due to political decree behave very unlike those that died of the virus. Namely, they are still around to seek revenge on those who were clearly responsible for their plight. Politicians should think about this now.

Isn't this basically what Donald Trump's plan is, that states like MI are doing, but Donald Trump is tweeting that MI should be liberated from? It seems pretty common sense to me, it seems pretty agreeable. I'd just like to make sure I am not the crazy one.

Sure the detail is hidden in (2) Stay 6 feet away from most people most of the time. It would preclude restaurants, most social gatherings, concerts, sporting events, most group sports, etc, no? That's basically what NYC is at right now anyway. Maybe more people would socialize in small private groups?

So sad we have to frame this in means like 'abolishing freedom' as if that was what anyone intended to do.

I think it is the wrong question. The right question would be “How do you feel about FORCED social distancing?”. And I would answer that I feel angry, impotent and pessimist for the future of my kids.

The question here is not utilitarian, it is ethical. I am sure in Sweden they are practicing a lot of voluntary social distancing. My mother in Italy would still remain at home alone even if social distancing had not been imposed.

@ Massimo, You do realize that without forced social distancing there's always one C-19 positive asshole who will infect everyone else? Recall Gaussian statistics, with 90% confidence a group of 30 or more people will have a 2 sigma outlier ( ie, an ass and a great person).

@Ray

I disagree. R is based on population level characteristics, and reducing transmission rates below 1 is a statistical property of 300 million actions. True, a few scofflaw super-spreaders can make a big difference, but they quickly get the disease and become non vectors, thus the virus has a negative attractor toward dying out. Which is what viruses pretty much always do.

Swedes don't normally go around making kissy face on eachother cheeks like they do in Italy, Spain, and France. I suspect just not doing shit like that turns a curve like Italys into a curve like Swedens. Go another step and don't shake hands, wear a mask, stay 6 feet away from people.

You don't need to literally hide in your house.

@HM , don't you know that stand offish lax C-19 Sweden has 5x the C-19 cases as strict lockdown, kissy face Greece? With the same size populations.

France has 148,000 case and 1,500 deaths and Sweden has 13,000 cases and 1400 deaths so no. You facts are just wrong.

Even if you go by population, France has 286 deaths/million population and sweden has 139.

Unless you were trying to be sarcastic or something ...

Er sorry france has 18,500 deaths. (My number 8 key is a bit sticky)

So the actual statistic is that Sweden has half the number of COVID deaths as France per capita, and that's without a lockdown.

For new cases that are showing up in the hospital or have tested positive recently, it would helpful to have some information on what these people were doing in the days and weeks prior. Are these recent cases arising mostly from people who are out working or otherwise not under house arrest? Many of us have now been away from the workplace for a month now. Presumably, we’ve been away from other people outside of immediate family as much as possible as well. Just wondering.

Your kind of weirdo suffers from hubris.

I started my career in engineering where's almost everything's knowledgeable and quantifiable and then specialized into hydrogeology where the work is literally that fable of blind men descovering an elephant by touch. The blind than touches a leg says the elephant is like a tree trunk, the one than touches the tail says the elephant is like a rope, the one that touches the ear says the elephant it's like a carpet and so on......

Natural systems are incredibly complex. We are trying to reconstruct a whole from its parts, for example reconstruct a 3D body from points.

You can tell there's panic and overreaction in Europe. There's China revising deaths 50% up because of....whatever. There's Taiwan applying 33K USD fines to people not respecting.....whatever. Sweden where your kind of weirdo is on charge, then please look daily at the Avlidna/death number per day and divide by 10.23 million people. Compare to other developed and emerging economies, report back.

PS. Prof. Cowen FT Alphaville is doing a much better work in dissecting the current situation. It's never late to relearn. I miss the trolley problem days at MR :/ https://ftalphaville.ft.com/2020/04/15/1586943153000/Why-are-we-really-in-lockdown--/

@Axa, yeah right. If you were a real engineer rather than a failed one or a troll you'd know how a stick figure FBD (free body diagram) predicts about 90% of a solution, including your "Natural systems are incredibly complex" problems. If you knew programming, you'd know a few lines of code can give rise to infinitely complex living patterns (eg, Conway's Game of Life).

Bonus trivia: Conway died the other day, of coronavirus! :(

So, you observe an extremely simple sim with just 3 rules can give rise to infinitely complex patterns. But you also say that a much more complex natural systems--with many more rules--can be readily known to the 90% level.

Phffft.

If you've ever looked a the predictions versus the reality of temperatures over the last few decades, you'd understand that people that do this for a living are a million miles away from the 90% mark. Their collective guesses are worse than coin flips.

Try again. Axa is right.

@P, you don't believe in the GW climate models, which have a wide range of outcomes? Debate is over, I will not engage with a flat earther...

“Social Distancing is Working so Well!”

This fills me with terror. Because I don't want this "shut everything down" mentality to become normal. I'm terrified of the precedent this is going to set for the future, that we're going to start to resort to heavy-handed government mandates in response to any health crisis.

You would rather endorse a lie than acknowledge a reality, in service our your ideology and concerns for the future? The reality is: it was a necessary desperate blunt act that worked as intended. Yes, it is time to start planning the next desperate necessary response. But serious people must start from acknowledged reality of where we are now. It worked as intended. Don't get sucked into obscuring that.

To allay your concerns, what we need to become "normal" is actual simple and modest (except the last two items):
- Place value on professionals and science.
- Place value on preparation.
- Clarify the roles for planning and response: state vs federal.
- Start supporting people instead of banks and CEOs, so our economic system is more resilient.
- Elect people who actually take the job of governance seriously.

So much of this could have been avoided with modest preparation and competent federal leadership.

If you come from a reactionary worldview that there is no such thing as competent federal leadership, you will never see a way out of your death vs depression dichotomy.

You have no imagination. There were and are other ways to solve problems like this besides authoritarian measures emulating China.

No. Not in that time and place there weren't.

Which is why the vast majority of other nations did the same thing, some even more drastically. And also why the majority of nations who did not do so, are, one by one, finding out they should have too.

What, you mean like Sweden? Japan?

About a week ago someone said 'look at Japan, the problem was small and is now fine'.

Go look at the last week's stats for Sweden and Japan in deaths per million. Look at their delta over time.

Yes, they have a "flatter" curve, without lockdowns. Their hospital systems are not overwhelmed.
If the strategy is flattening the curve and not total suppression, that should be fine.

I remember when this same argument was being made about the UK.

Meanwhile, Japan just joined the UK in it's oh crap moment

https://www.argusmedia.com/en/news/2097167-japan-declares-nationwide-state-of-emergency

You mean japan has joined the frenzy of "irrational" "human interconnectedness" that we're all supposed to be enjoying sharing at the moment.
They still only have 2 deaths per million, and a total of 190 deaths.

Keep up with the sophistry H, for a moment there you almost seemed like a human being.

"Keep up with the sophistry H, for a moment there you almost seemed like a human being."

That's the point where you lost the argument. There are good points on both sides of this debate, but you don't care to hear the other side. You just assume they are evil or inhuman and ignore the point that disagree with your world view.

No, it is in response to a different thread down below which he chose to bring up here.

Hazel is a she, you need to read more Heinlein, and more importantly your entire set of threads so far is hilarious out-group bias combined with the ad hominem fallacy.

Turing Test: failed

HM writes like a male

That's pretty sexist of you, to think that women have a special "feminine" writing style.

The experts have been frustrated that we don't obey them. Somehow, they confused their role as advisors to decision makers with the role of decision makers. We must obey, because they are smart, especially chess playing economists.

Have you considered for what "social distancing," the 6 ft personal space, is justified? On its face, it is because people are spitting spittle into each other's mouths and noses. How prevalent do you think this is happening and no one has noticed?

The "social distancing" and hand washing are more ritual than science outside of interaction with an actual symptomatic person for a significant period of time. There are no documented random passer-by or random surface transmissions. These are the go-to suppositions when there is community and nosocomial spread. Not unfounded in logic, but not proven to justify their fetishism.

On the other hand, there are documented clusters of spread via family, work and social group events. In Illinois, two family gatherings with communal food, embraces and prolonged face to face conversations with people who were later confirmed to have the virus where spreading occurred.

It is group events and crowds where people are in prolonged contact that we have to prevent. Not randomly getting within 6 ft of someone for a few seconds or even single digit minutes.

Almost all cases of transmission have been indoors. It may be possible, but I don't know if it is being investigated, that outdoor, well-ventilated crowd events might not be very risky.

CDC's website on COVID-19: (Note the "prolonged period")

"Why practice social distancing?

"COVID-19 spreads mainly among people who are in close contact (within about 6 feet) for a prolonged period. Spread happens when an infected person coughs, sneezes, or talks, and droplets from their mouth or nose are launched into the air and land in the mouths or noses of people nearby. The droplets can also be inhaled into the lungs. Recent studies indicate that people who are infected but do not have symptoms likely also play a role in the spread of COVID-19.

"It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or eyes. However, this is not thought to be the main way the virus spreads. COVID-19 can live for hours or days on a surface, depending on factors such as sun light and humidity. Social distancing helps limit contact with infected people and contaminated surfaces."

A too rare voice of reason.

I just noticed "COVID-19 can live for hours or days on a surface..." in the CDC guidance above.

Can we really trust a government agency tasked with disease control when they use the name of the disease (COVID-19) instead of the virus (SAR-CoV-2) and speak of a virus as "living". Viruses remain stable in the environment and even then the research didn't test infectivity even when they found intact virus RNA.

I suppose we can say a disease "spreads" but the above sentence is about the virus not the disease and shows poor professionalism and expertise.

Consistent with CDC telling people not to use masks for SARS-1, swine flu, and now SARS-CoV-2... and coming up with a fake PCR test for old-technology machines, while FDA banned all the real tests for months.

The reporting on this is tragically absent.

Thank you. We should all be able to go back to work as long as we stay in our cubicles and don't come within 6 feet of other employees. Or wear a mask. This isn't that hard. We don't need heavy-handed mandates to literally stay in our homes. We don't need shutdowns of "non-essential" businesses.

Ever go to a party and meet a close talker? Somebody that double dips their chips? (often a kid) That's why we need manditory lockdowns, to either flatten the curve to allow ER hospitals to treat oldsters, or, like in Greece, bring R0 below zero. It's not you but that one rotten apple in the barrel that's the problem.

Maybe should make it a federal crime to double dip or something. It would have less effect on the economy.

It's a rule of thumb. Do we have clear scientific evidence that, say, outdoor concerts do not spread covid-19? If not, why risk it at this point? What about the Smithfield meatpacking hotspot? Was the spread caused by social contact among workers or merely incidental contact?

There is still much we simply do not know.

China has studied and they believe outdoor transmission is incredibly rare. Being outside is probably the best place you can be. And that makes sense, too. The smallest of air turbulence will rapidly disperse the virus.

https://www.nationalreview.com/corner/coronavirus-transmission-chinese-study-shows-covid-more-likely-spread-indoors/

There is no clear scientific evidence that social distancing or hand washing prevents the virus. There isn't even any scientific evidence that people are spittling into each other's faces.

For some reason the CDC and WHO will not entertain the studies that show respiratory viruses can remain airborne in poorly-ventilated spaces and be breathed in. And that aerosol transmission is just as plausible as droplet transmission and more plausible than fomite (surface) transmission. The closest the CDC comes is "The droplets can also be inhaled into the lungs. "

This is from a March 17 letter to the New England Journal of Medicine signed by 4 NIAID (Dr. Fauci heads), 4 CDC and 2 university researchers.

"Our results indicate that aerosol and fomite transmission of SARS-CoV-2 is plausible, since the virus can remain viable and infectious in aerosols for hours and on surfaces up to days (depending on the inoculum shed)."

"There is no clear scientific evidence that...hand washing prevents the virus."

What? I thought this was literally a "soap dissolving phospholipid membranes" argument. No?

Soap denatures lipid encased virus, but there is no evidence that fomite transmission is a significant vector. Possible in healthcare settings due to the viral load on things but unlikely on a random item in store where virus may have been deposited by a symptomatic person.

"The risk of transmission with more indirect contact (eg, passing someone with infection on the street, handling items that were previously handled by someone with infection) is not well established and is likely low."

https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-epidemiology-virology-clinical-features-diagnosis-and-prevention#H3174740477

The questions to ask:

Where would we be if we had devoted $300 billion to preparation six months ago?

Where would we be if we devoted $4 trillion in support directly to the people, rather than to banks?

Actually, half of the $2 trillion dollar "stimulus" bill went to government. Federal agencies and states. Didn't go to banks or the people.

If you had 6 months of warning, then you'd not need all that money. If people knew it was coming, then PPE factories would have started working triple shifts and stockpiling. In wartime or under extreme pressure a factory can double production quarterly on complex products (airplanes and phones). So, a PPE factory running on July 2019 would triple output by triple shifts, and then would have two doublings. So, come December 31 2019 they'd be making 12X what they normally make. Easily.

All you'd have to do to ensure that happened would be to write the checks. If the orders are there and the cash is in hand, the process will start.

But that has always been true. Everyone knew this was coming, but the CDC chose to focus on vaping, pronouns and bullying. The CDC could have peeled of a few % of their budget each year and spent that instead on PPE ramp up over the last decade. Instead, they decided it was a better use of funds to make "no bullying!" coloring books.

>> Where would we be if we devoted $4 trillion in support directly to the people, rather than to banks?

You do need lenders for people to thrive. If you just gave the money to consumers (the $4T would be $52K per family of 4) much of that would be spent on stuff that completely escaped our market. For example, if you give a family $50K and they buy products made in China, then that was a very poor use of the money--you basically put on your credit card purchases that didn't accomplish a thing.

And not that much of this went to banks. Much went to buybacks of everything from treasuries to mortgage backed securities, financing for small businesses, funding vaccine research, money to states to help them meet obligations, unemployment, medicaid, etc.

"You need banks." No, that's the myth that has not been tested. I propose giving people the cash to spend. People don't NEED lenders. But lenders need people to borrow.

The vast majority of the money devoted recently went to banks (writ large), and large corporations. Far in excess of the amount that went to individuals (which is still mainly not getting there). The headline $2 trillion was not even half if you include the Fed.

And yes, I chose a large number for preparation cost. That was my point. But you act as if the CDC is some remote sovereign power like Russia. It is operated by Trump appointees, it's budget is controlled by Trump budgets, it's priorities are set as Trump's priorities. That's how it works in the USA.

How about a combination of relief that we have averted an immediate catastrophe, worry that we need to reopen but might trip doing so, and despair at some of the other reactions I see?

It is in the "tripping" that the problem lies. If you are an on-the-ropes restaurant owner are you going to buy perishable foodstuffs to reopen when the slightest panic by state and local officials may shut you down again, now with either debt you can't pay or just lost savings that is now being thrown out as it spoils?

This is the thing I don't get, and granted I'm in NYC where it's different. The vast majority of people want to stay in and avoid these risks. That might not be true in TN, yet. To whatever extent TN doesn't do what NYC did, it WILL become true in TN and I ask, who will go to your restaurants then? Reopening, not the closure, is the cut to the nose that spites the face.

This post reveals the essentially sad, lonesome, and uninspiring view that often seems to be at the root of Libertarians.

A distrust of the human spirit. A distaste for expressions of love. A disdain for simple intangible connectedness. A rejection of expressions of emotion. An insistence on life only motivated by greed and measured by money.

This lockdown, regardless of anything else, IS a remarkable human event. Irrational indeed. Dangerously unpredictable and resistant to modeling, to quantifying, to putting in a nice safe box.

The possibility that this arises from a positive human trait cannot be allowed to exist. It MUST be a sign of human weakness. It MUST be evidence of totalitarian control.

And so it must be killed.

Oh, I see, we should all enjoy the authoritarian control of our lives because it is part of a an irrational but unifying moment of social solidarity. Why does this sound vaguely familiar, for some reason.... ?

I mean, the thought that some of us might have had plans to do something else this spring besides enjoy a good unifying plague experience hasn't even occurred to you. This is what society decided to do today, so we all need to get with the program, and like it!

Like I said.

The hostility seems to come from a distrust of human connectedness and manifests in mocking it as a hallucination.

There were some other groups of people last century that enjoyed "human connectedness" and the results of their enjoyment of it were unpleasant.

It's quite sad that your only conception of human love is that it inevitably leads to communist concentration camps.

You have an extremely bizarre and uncharitable mental model of libertarians.

Turing Test: Failed

And Libertarians have an extremely sad and uncharitable mental model of humanity. HM, for example, seems to equate finding human connectedness during a crisis to be connected only to a communist holocaust.

You’re better at reading comprehension than this.

Reread her comments.

I reread it several times.

In response to a post by TC that mocked and dismissed human responses to this lockdown that celebrate humanity, and in the context of an overall push from the right to favor the economy at the expense of increased unnecessary deaths, I made an (admittedly snarky but in fact serious) observation about the mental model this sort of line of rhetoric seemed to imply.

And in response to that, HM went immediately and unambiguously all-in with a reductio absurdum strawman equating the aforementioned human sentiment to the justification for communist murder camps.

Really, that's simply the right-wing version of Godwin's law. Which HZ pulled out on the first effort.

"human responses to this lockdown that celebrate humanity"

I celebrate humanity with authoritarian orders to shut down all businesses and order people to stay indoors!

It is you that has weird ideas about what constitutes an appreciation of "human connectedness" and "love". Not libertarians.

I understand this is difficult for you to accept.

Governors and city/county health officials asked hundreds of millions of people to stay in their houses. And they did. And they are making the best of it.

No national guard. No home guard. No see something say something. No surveillance. None of the fascist/commie crap. Just a press release.

A little bit of fear and self-interest, sure. Some peer pressure, okay. Some major ecomonic pain and uncertainty, true.

And yet they are doing it. And they have for weeks. Mainly because they believe it will help their friends who work in hospitals. And help their neighbors.

Some people find that inspiring. You seem to find it despicable. And that's sad.

Going along with whatever the government says is necessary is not inherently a good thing. There's more then a little peer pressure going on. What if everyone is just wrong that this is all necessary to do this? Then what they are collectively engaged in is massively destructive to humans livelihoods and lives. Collective mob passions are not necessarily a wonderful thing to be celebrated. A month ago everyone was shaming people on social media for wearing masks in public, saying that they didn't help, because they were blindly following the CDC's advice. And in your original post you actually admitted that it might be "irrational", but then argued we should all go along with it anyway because it was born out of some moment of social solidarity - just enjoy the irrational fear and panic and unnecessary destruction going on around us because , hey, people are doing it out of "love" (yeah, sure). Well, society needs people who are going to tell the mob when they are being stupid too. There's plenty of examples over history of society doing terrible things because they let their collective passions and desire for a feeling of social unity overcome reason. Some would argue that "patriotism" is a form of love, too, and yet that has led to war and genocide.

"Well, society needs people who are going to tell the mob when they are being stupid too."

Sure, let's hope that they are not being completely idiotic in doing so!

This one's easy. Tyler has never experienced real fear about his personal safety before.

A lot of college faculty fear being thrown into the pool of college students who come from all over, and attend class thinking they have a hangover and are really sick.

“ Most likely it is bad news if the relative safety (for some) of the current moment comes from social distancing. Because at some point social distancing must end, or at least be significantly curtailed, and then a higher danger level may well reemerge.”

Think you are too pessimistic.

Isolation gets to zero/near zero cases. Then public health apparatus & innovations (app) & moderate social distancing help keep virus at near zero level (S Korea & Taiwan).

When you say “social distancing must end,” I simply don’t expect that to happen until there is a vaccine or eradication.

Pandemics are confusing times for natural contrarians. I say this from personal experience and I think it's reflected also in some of Tyler's hot takes.

It’s the rock and the hard place. Both strategies have costs. The cost of lives, the economic costs. The elites tend to favor social distancing, they’re more insulated from the economic costs at least short term, they’re generally older too.
The working people, the people of modest means who can’t work from home suffer the most from the shutdown.
The shutdown doesn’t work well. It’s a leaky shutdown, people are still dying of Covid. It’s a slow bleed that will take a long time.
It’s easier to take the deaths all at once. It’s like a natural disaster. We recover from that fairly quickly.
New York is at least 20% immune now. Reopen in May with masks mandatory. .
I think with masks, you can get 2/3 of the shutdown ( leaky shutdown) but only 4/5 of the pain (large social events still on hold).

Here is a visual on how effective masks are using laser light scattering. It’s effective.

https://www.nejm.org/doi/full/10.1056/NEJMc2007800

In the US, I would say tech and government has been fairly ineffective in this pandemic.
The things that work were known in the Middle Ages( quarantine. masks)
-Tests: not scaling well, not giving answers on prevalence
- models: all over the place , little predictive value
- contact tracing ; inexistent and not ready soon
- ventilators: helpful but hurtful: low survival rates
- treatments : mostly stabilizing people and hoping for the best , no working drugs
- vaccines and antivirals : too far away to help.

Tens of thousands of North American meat packing workers, who have not been going to work at all instead of risking they and their families getting infected.

Common sense should prevail as to precautions. Masks and gloves should be used. It’s doable. I had a dead battery and a AAA guy came over. He had masks and gloves. We didn’t interacted much. It works.
When will the meat packing workers return ? When a vaccine is available ? How does that work ?

"When will the meat packing workers return ?"

Who knows - the decision is entirely up to them, since they are not slaves or forced laborers. However, it appears that if the plants want to stay open, they will need to reduce operations by something like a quarter or third. as people currently work very closely together.

They are not slaves.

You seem to have missed the entire twentieth century. The form of slavery changed. You can look it up.

The thing that "works well" on coronaviruses is sunlight. Look at Australia and New Zealand that got hit in summer, look at India that's always sunny.

An hour of sunlight can give you 10,000 IU of Vitamin D... so it's not going to kill you to take 2000 in a pill ;)

Tyler: can someone do something for big business for once please????

«How do you feel about that statement? I take this as one psychometric test.

If your reaction is: “My goodness, these are tragic times but it is splendid and noble how we all can come together and sacrifice for a common endeavor!”…well…

…you have failed my test and I will suspect a wee bit of mood affiliation.»

Perhaps more probably, someone that never liked "social proximity" in first place.

If I get where I think this is going, then it almost seems we are lucky (although these things are never totally accidental) that the kinds of people who might be most likely to voluntarily break the lockdown are exactly the kind of young risk-hungry superspreaders that we need to make immune, and can make immune without killing.

The flash points will be in places where risk averse or vulnerable people are involuntarily forced to share air pockets with the risk hungry. Houseshares, families with young adults. A workplace where remote working is not possible but half the workers are cautious and go straight home wearing masks and the other half go to a speakeasy.

But I still think the most plausible infection rates suggest we will reach herd immunity within 3-6 months, even if distancing compliance is relatively good. Hard lockdowns in EU have only barely got R below 1.

Is it a "pass" to be thinking aloud about "optimal control policies for number of active cases"?

Another data point, from the U.S. aircraft carrier Theodore Roosevelt:

- 94% of 4,800 member crew tested (testing still ongoing)
- 600+ sailors (~ 13% of the crew) tested positive
- 60% who tested positive have not shown symptoms

https://www.reuters.com/article/us-health-coronavirus-usa-military-sympt/coronavirus-clue-most-cases-aboard-u-s-aircraft-carrier-are-symptom-free-idUSKCN21Y2GB

Almost the same results of Diamond Princess.

Stanford random anti-body testing in CA results just came in this morning. Roughly 3.3% of the general pop in santa clara has antibodies. For the first time, we know the numerator of a general population (3300 tested). Which means the death rate of the virus is 0.5%. But death rate in places like King County (Seattle) for those 0..60 years old (working age), that's just 8% of all deaths.

Which means the working-age death rate is ~0.04%. The same as flu.

BACK TO WORK!

I have a modest proposal.

Everyone registers as an "innie" or an "outie." Then they get a tattoo saying so.

Then the outies go out and do whatever they want (within the law).

The outies get access to their proportional share of medical supplies and hospital capacity as it stands now. (Staffed by medical providers who are also voluntereed as outies). The rest of the supplies are locked in reserve.

Workers in public facing hourly jobs are given the same choice, and offered the opportunity to work at whatever the market will pay, or to get 75% of their previous pay as unemployment if they choose innie).

If you get infected assuming testing is available), you go into an isolation camp (okay, a hotel) for two weeks.

After six weeks, the outies can preen and say I told you so. Or not. We'll see.

Interesting point, counterpoint. I still prefer the Battle of the Wits from The Princess Bride!
https://youtu.be/rMz7JBRbmNo

Hi different George

Ha! Apologies. I didn't even consider another George commentor, let alone another who may have commented directly before me!

No worries, There are drawbacks to the open and easy posting format.

that's a different George

Couldn't someone be happy that social distancing is working well, a bit anxious about what will happen when it's lifted, but also optimistic because the rapid reduction in cases, due to social distancing, combined with the other measures being taken (stockpiling healthcare and testing supplies), mean that likely some reopening will happen soon, and happen successfully? I think that Tyler forgets that some people live in countries where the government's response is basically competent, and feel optimistic about the future.

never thought I’d feel so validated while at the same time being called a weirdo

Put me down in the column where those who agree with the statement, but who also see it as unsustainable and could lead to a worse situation, but probably will not. I don't recall seeing TC's preferred "epidemic management" plan would be, if he were in control of both the Executive and Legislative. Is it much different that what the 'common wisdom' says: more testing, targeted relaxation of regulations (and legislation), and liability coverage for those whose actions deserve it. But the post was about Social Distancing, which seems to be about where it should be - given it's only been about 4 weeks. What should be farther advanced is our planning - which still seems reactionary to me.

Much of social distancing has been in place for years, before COVID-19, even if your livelihood depends on people pretending otherwise.

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