I think this theory gives way too much credit to governmental competence. I think Yes Minister's Four Stage Strategy is a much more accurate assessment:
Standard Foreign Office response in a time of crisis:
In stage one we say nothing is going to happen.
Stage two, we say something may be about to happen, but we should do nothing about it.
In stage three, we say that maybe we should do something about it, but there's nothing we can do.
Stage four, we say maybe there was something we could have done, but it's too late now.
It's disappointing that the WHO and national agencies seem not able to adequately inform the public about their assessment of the situations, the models they're using and the conclusions they're drawing.
Right now, the most shared article on Corona is written by a growth hacker from SF who cobbled together an Excel sheet and recommends it to people to decide whether they should close their companies or stay at home.
I'm not saying this is bad, I just think such recommendations and articles should come from people that have more experience with modeling such epidemics.
Fitting a dataset with an exponential function is easy, it just doesn't tell us much beyond the current growth rate. It's also a bit ridiculous to judge how bad the situation is in a given country without accounting for differences like the number of tests that are done and the overall population of these countries.
It is surprising to me to. If this was Star Trek world, you'd have computational models built by experts shared and discussed the very first day, forming the very foundation of the discussion and policy around the virus.
I know of a certain company whose entire purpose is building and selling a product that lets you plug in equations of complex, dynamic systems and play with the models to understand and predict things. Like serious, industrial-grade stuff that's used to design chemical plants. They could easily get a virologist on call and model the spread more sensibly, or even individual countries in detail, and release that - which would give a basis for people to discuss what to do and when in a much better way that's happening now. They'd probably also save themselves a year's worth of marketing expenses. But I don't see them, or any of their competitors doing anything like this.
I'm thoroughly disappointed. Is the ArcGIS dashboard from John Hopkins University really the best our civilization has to offer in terms of informing people and evidence-based discussions? Because while I want to believe that our politicians have more sophisticated tools available, I'm pretty sure they're just looking at the same dashboards and same news stories as we do.
The trouble is that pretty much all of the data is garbage quality, and if you feed garbage into a computer you of course just get garbage out. The figures from Wuhan are particularly bad, probably just a function of their testing ramp-up until well after the peak, and the ones from Italy might not be much better. (The other problem is that China has taken the position that their numbers are an exact description of reality and their approach is a model for the rest of the world to follow, basically for domestic political reasons, and the WHO seems to be eagerly regurgitating this to the many people who'll listen.)
I wouldn't necessarily call the data "garbage" but the numbers are definitely _soft_.
But soft numbers are a common issue with many areas of public health. In particular, analysis of the current pandemic suffers from both a "numerator" and "denominator" problem (http://conflict.lshtm.ac.uk/page_83.htm)
I think many of us are accustomed to getting high-quality stats when studying a process. But that's often not possible with a fast-moving public health issue.
I think you have to acknowledge the limitations of the data, but it can still be helpful.
The thing I _don't_ like about the JHU dashboard is that it doesn't really let you slice the data in interesting ways. For example, I'd like to be able to click on a country or state/province and see temporal data. This doesn't seem like it would be that difficult, but maybe I'm naive.
I've tried doing some stuff with the Italian data but got a similar roadblock. For example, I'd be interested in knowing, among the ICU cases, if these cases were new (people arrived in the ICU with a diagnosis) or a worsening of the already existing patients (perhaps in sub-intensive care earlier).
It would help forming an idea on how the current situation (in addition to the new cases) is going.
Is there an open data portal for emergency room visit stats? That would probably paint a better picture of the real case count, by showing us whether there's a spike in visits for acute respiratory illness.
That kind of tool will give you accuracy without precision. There are so many unknown assumptions involved that a model like that is going to give at most qualitatively correct results.
People who model the effects of climate change, like Nate Silver and the 538 crew, run thousands of simulations and present a summary. Even then you can get hung up on the "unknown unknowns".
For instance 1970s estimates of nuclear reactor accidents assumed the main risk was that the pressure vessel was going to burst. That's an easy risk to control, so you hardly ever hear of a pressure vessel bursting at a chemical plant, but all the time people blow up or suck in storage tanks that can't handle 1 psi of under or overpressure.
Now really a legacy nuclear power plant melts down 100% of the time if the power goes out and they can't start the emergency generators. That happens a lot more than bursting pressure vessels!
I'm not saying someone should throw a model with 100 parameters and say it's the truth. But you could incrementally build up a model for questions like "should we close schools and when", refining it step by step and getting a range of outcomes, a probability distribution. Sure, the precision is still limited, but it's much, much better than how the discussion looks today: "oh, our government decided to close all schools for the next two weeks, I guess that buys us a couple of days, so we're maybe no longer 3 weeks behind Italy, but 4". Because that's the level of the discussion on the smarter end.
My point is: we have the tooling necessary to talk about this problem better, more accurately, more precisely, in real-time, and to cover more angles simultaneously - which would lead to better decisions. But we're not using it. At least not publicly.
(This is a part of a general issue of mine, that we absolutely suck at having any kind of data-based discussion; best what we do is exchange badly made charts and context-free data points. We should be exchanging and discussing whole dynamic models. But I suppose this wider issue can wait until we're done with the coronavirus mess.)
We’re in a real situation where choices (or the lack thereof) will have major consequences. If the best estimate we can make is a rough one, it’s still sensible to use it as a guide for our actions.
The third option is "because they don't want to be blamed for model error". Governments aren't necessarily competent, but you can try to get them to understand 5%/95% confidence intervals, at least in hindsight. If you publicly release a prediction, and then the real outcome is the 10% confidence line, you're probably going to be yelled at for being wrong regardless of the error bars.
Of course, if the center of the prediction is horrifying, "people don't understand confidence intervals" then becomes a case of avoiding societal breakdown.
Industrial grade is the key word here. They have there customers, so they don't need "cheap" PR. They are specialized in chemical plants, usually professional organizations know there limits (conditions apply). Plus, the WHO and others have these models and tools as well. Plus the domain knowledge needed.
Why wo don't have anything from these bodies is a different story, so.
> Plus, the WHO and others have these models and tools as well.
Assuming they have[0], my core issue is: why won't they share them? Society is not 100% made of illiterate rubes who can only add (but not multiply) and read a line chart (and get confused by a log scale). There's enough people who could make use of more sophisticated information, including politicians and political advisors.
The discussion about e.g. whether a country should stop mass gatherings now or later would be infinitely better if it wasn't just "I think so" and "we have to flatten the curve!!11", but instead if one could say "look, the WHO model shows it won't help much", or "an alternative model proposed by virologist X suggests that it has most benefits if done today; here, look at this chart", especially if people could play with the models themselves and propose corrections.
--
[0] - I'm not convinced; I have the feeling most work in this space is still done with Excel or basic Python and R toolkits.
“Flatten the curve” is a reference to a chart suggesting it has the most benefits if done today. I can imagine objections about the parameters of the chart or the authoritativeness of the source, but I haven’t seen anyone argue against it on those terms; the vast majority of counter arguments I’ve seen are casual dismissals that it could become so bad when things are mostly OK today.
You are basically asking the same question I am. Why are they not sharing this kind of things? I think it is because the majority of the population is illiterate in that regard. This whole "exponetial growth modelling" going shows this pretty clearly. Not showing just opens a door they are not aware of I think.
also, I don't care about the tools they use. As lonfg as the results are correct.
> There's enough people who could make use of more sophisticated information, including politicians and political advisors.
Far be it from me to suggest politicians and political advisors are "illiterate rubes", however I can tell you with confidence that in my experience politicians don't like numbers and models and won't listen to you if you try to tell them about them. Fundamentally this means that even when they're not actually illiterate, they are functionally illiterate (unless of course said model serves their political interest exactly).
>It is surprising to me to. If this was Star Trek world, you'd have computational models built by experts shared and discussed the very first day
The problem with Star Trek (esp. TNG) is that it doesn't reflect reality at all. It gives you the idea that the people in charge really know what they're doing and are competent. In our reality, this simply isn't the case.
I love watching TNG reruns to relax. It lets me fantasize about living in a well-run society run by mostly competent people. That's not the society I live in now, but this is why this form of entertainment is called "escapist".
Exactly this! I kind of understand the WHO, the broad public, including media, doesn't care about models and such things. Providing to much details can have the opposite effect, instead of calming things down it could spark more fear.
On the other hand, online stuff like said growth hacker can draw a lot of attention. This will end up in the mainstream. That diseases aren't exponential, who cares when exponential curves fit so nicely early on.
What could, and should, be done by large tech companies is preventing this. Google could make sure that every Corona related search ends up showing the WHO on top, followed by local sources like the CDC, Robert Koch, John Hopkins and so on. They could support these parties in getting them up in the search results. Facebook could do the same, as does Twitter. In Germany, you have to explicitly include Robert Koch or RKI in your search for the link to show. Even by doing so, earlier today it still wasn't the tip link. The rest is reporting crap written every time a new case was found somewhere.
> That diseases aren't exponential, who cares when exponential curves fit so nicely early on.
Shouting this point does more bad than good. Outbreaks are exponential in their initial stage, to an extremely good level of approximation. Sure, they're ultimately s-shaped, but we're far from the bend point. That the growth starts to deviate from the exponent a tiny bit when half of your country is sick isn't a useful observation right now.
You don't have to wait until half the country is sick, though. If you restrict movement, you see a sharp reduction in transmission when you start getting neighborhoods hitting 50%. Some will get there faster than others.
So how do you explain South Korea? Their cases have decisively peaked. So one of three things happened;
1) Herd immunity has kicked in, meaning a majority of people have already been infected and are recovering/recovered
2) Containment measures were effective against a highly communicative virus which can live in the air for 3 hours and on surfaces for up to 12 hours.
3) They just stopped testing and/or are lying about the results and are hiding the resulting health care burden.
IMO the only one here that doesn’t require competency on the part of the government is #1, making it by far the most likely scenario.
If #1 is true to any extent, then it means IFR is actually quite low, more like 2009’s H1N1.
The other fundamental question I keep going back and forth on is the final total population infection rate. For H1N1 and other flus it’s usually on the order of 10-30% of the population. (There are arguments why this one might be higher, although I think some people confuse exposure numbers with infection numbers...)
Containment supposedly will not meaningfully reduce this ultimate number but would just slow down how long it takes for everyone to ultimately be exposed.
So while there are very few new cases in China (and they are closing their temporary hospitals) what happens when people go back to work?
When comparing countries (e.g. Italy against South Korea), you have to consider many factors.
Cultural factors: how quickly do people change their habits, to do e.g. social distancing. Do people in public wear surgical masks. Population density, temperature, weather,...
Lying governments: I don't think South Korea or Italy are lying, but Iran is for sure, and China up to some point (at least early on). Italy stopped testing at some point, but this is known. South Korea increased testing over time.
Herd immunity: maybe a part of the population was already immune before (too early to say), but it couldn't have "kicked in" during this year as there was only one wave yet.
There is no question whatsoever that this corona virus IFR is a lot higher than the 2009 H1N1 flu, but lower than the 1918 H1N1 flu. When comparing countries / regions, you should consider the population age pyramid (Italy has more old people than South Korea) and how overwhelmed the hospitals are (I think quite bad in Italy and Wuhan).
A co-worker from Italy told me. But you can find this for example here as well: https://www.aljazeera.com/news/2020/03/italy-south-korea-dif... "Italy started out testing widely, then narrowed the focus so that now, authorities do not have to process hundreds of thousands of tests." (I don't normally read Aljazeera... just found this using Google.) It matches what my co-worker told me. See also https://www.worldometers.info/coronavirus/covid-19-testing/ (I have no clue how reliable that source is)
I live in Italy and I'm not aware of any changes in the procedure for testing.
If I read the worldometer link you provided what I see is that both on March 2nd and on March 9th Italy was second only to Korea in number of tests performed and that we moved from 386 tests per million people to 1005 in the same period. What am I reading wrong?
Yup. But to make that point, you have to show the trend that the disease will follow if you won't restrict movement - and shouting that "it's an S curve, not exponential" isn't particularly helpful here.
But the early stages of disease spread _are_ exponential. And I find that people really fail to understand the meaning of that, and how scary numbers like "new confirmed cases doubling every two days, 500 new cases in France yesterday" truly are.
The problem is, exponential for how long?
For instance, all seems to indicate measures in Italy are taken too late: and the exponential growth is still happening there (almost 3 weeks after the problem started)
import pandas as pd
import numpy as np
import matplotlib.pyplot as plt
%matplotlib inline
it = pd.read_json('https://raw.githubusercontent.com/pcm-dpc/COVID-19/master/dati-json/dpc-covid19-ita-andamento-nazionale.json',
convert_dates=True).set_index('data')
plt.plot(it[['deceduti', 'totale_casi']])
plt.xticks(it.index.values, rotation=90);
It's to early to say. The people who are popping up with symptoms now might have been infected up to two weeks ago.
If you look at the Wuhan data, you see that the lockdown worked, but the number of confirmed cases at the time continued to rise dramatically until 12 days after the lockdown went into effect. We are only three days in on the Italy lockdown.
Yes, but extrapolating the early exponential phase is, plain and simple, mathematically wrong. No idea why data scientists aren't going the first mile and look up the relevant functions before spitting data out. Total fail on their part, IMHO.
It's not wrong: it has produced extremely good predictive results day after day for total cases outside of China for months now. Using a simpler approximate function in place of a more complicated exact function is far from wrong, it is bread and butter for getting practical results in all areas of science.
Countries that implemented extreme measures to slow the spread of the virus. It will be different for countries which haven't. The WHO and other health officials around the world are saying the same thing. This will spread to a large number of people. It's too late for containment, you can only hope to flatten the curve. That's why it's now a pandemic.
Unless you simultaneously ramp up your healthcare resources (what China did), even as "low" as 100 cases/day still has very real potential to go exponential (R0=2.5), overwhelm your healthcare, and kill 10% of our population if not more (especially if your population is aged).
I hear that, what I'm saying is, follow that logic through... If it's crucial to maintain strict protocols even during a rate of only 100 new cases/day, that means these protocols stay in place roughly... indefinitely.
Counting individual cases and deaths in a country of 300 million is nonsensical. You could do the same thing with the flu and you'd hit 20,000 deaths a year and you'd destroy the economy in the process.
IMO, the solution is best preparing to treat the number of people who do become severely ill from it, and getting the rest of the country fully back to work as quickly as possible.
Although I disagree strongly on the "kill 10% of your population" bit, which is just fear-mongering, it's kind of besides the point.
>Although I disagree strongly on the "kill 10% of your population" bit, which is just fear-mongering, it's kind of besides the point.
If every case went untreated, 10% is a reasonable guess about what the death rate would be. Unchecked growth would lead to almost every case going untreated. That's the penalty for allowing the number of active cases to rise above five times the number of open beds/ventilators.
Mathematically wrong is not a relevant category here. There is no "ground truth" that is approximated by an exponential growth. Every disease model is counterfactual "spread of the disease if no countermeasures were taken", etc...
Modelling the beginning of an epidemic as exponential growth is useful, sensible and empirically validated. As, countermeasures are taken during the beginning of the epidemic, for discussions of the effect of countermeasures, exponential is the correct model.
In fact, hopefully the countermeasures taken will be sufficient that the intrinsic disease dynamic will never get past the exponential stage...
If you find any source, idealy scientific papers on the subject, that shows that contagious diseases can be modelled with simple exponential functions, please share them. I am not an expert on that matter, so I would be really interessted to see some reliable sources confirming the use of exponential functions.
Notice that the rate of change in the infected population (dI/dt) is proportional to the current number of infected (I) and the current number of susceptible (S).
In the early stages, when S is large and I is still small, this acts just like an exponential function in I.
For example, think about what happens when you double I the first several times. S stays relatively unchanged, and so dI/dt roughly doubles each time you double I.
Yeah, exactly. In the beginning exponential, later on not anymore. Without changing the equation. So, no, not exponential. Because, you know, very early on an exponential graph can approximated by something non-exponential. Would be utter BS, sure, so nobody does it.
Exponential growth. It's the growth phase that matters.
People keep mentioning the exponential because both of these curves, at an important point in time, grow very fast. Much faster than anything you're likely to encounter in daily life, so the public really doesn't have the requisite intuition.
But I can see you're not interested in understanding the point. You asked for equations, I gave you equations. Good day sir.
We are, I think, not disagreeing at all. May sound crazy, but bear with me a second here. I know that the initial phase of any epidemic is exponential. Key are these three small words, initial growth phase. Because they make all the difference, as every epidemic will ultimately peak.
These three words are simply to often drowned out in discussions about COVID-19. That's we you see extrapolations of this growth against, for example, the population of Italy. And this is dangerous. And I don't think we disagree here, I never disputed the exponential nature of the early phase.
We just shouldn't make the mistake in assuming everybody catches these three little words, especially not online.
The most critical question everybody is trying to answer right now is, when the peak will be. And whether this peak will to high for our medical infrastructure. With all the measures being taken, the conclusion seems to be the point will be too high. Hence the counter measures. So we should all do what we can to flatten the curve as much as possible. I never said anything else, and honestly, I don't see where are disagreeing here.
S = N - I - R, and lets used normalized ratios, so i = I/N, r = R/N, etc... so the dynamics of i are given by:
di/dt = beta (1 - i - r) i - gamma i
di/dt = (beta - gamma) i - beta (i^2 + ri)
At the beginning of the disease, the ratio of infected and recovered is very small, say 1e-5 for 100 cases in a population of 10 million. So initially the second term is 1e-10 whereas the first is 1e-5. The initial dynamics of a new disease are given by:
di/dt ~ (beta - gamma) i
exponential growth. It will start deviating from exponential growth once i becomes large enough. If 10% of the population have had the disease it will deviate from exponential growth by 10%. Once it gets to half the population being infected or recovered you start seeing a real deviation.
In reality this might never happen, because we are taking a lot of measures to get beta down. So really you have something like
di/dt ~ (beta(t) - gamma) i
where beta(t) will capture all the countermeasures people take. If the countermeasures are effective and manage to push beta(t) below gamma before a large chunk of the population is infected, we might never see non-exponential behaviour from the disease. It will have an exponentially growing phase, and then an exponentially shrinking phase.
---
Here is just one paper I found with two seconds of google that looks at this, very recent, a bit basic:
"The initial exponential growth rate of an epidemic is an important measure of the severeness of the epidemic, and is also closely related to the basic reproduction number."
"Classical compartmental transmission models assume exponential growth during the early phase of a well-mixed population"
Key word, initial. Later on, not so much. Which is the whole point, pandemics aren't exponential over the complete run time. So, why not using these formulas at least in the models instead of using exponential equation limited by world population?
Edit:
"It will have an exponentially growing phase, and then an exponentially shrinking phase"
Confirming the point above. Math is a precise science, it's a while since I did stuff like that, but getting equations right or not used to be a big deal back than. And now we talking more serious things than just a grade in an exam.
Okay you're just trolling now. We are very much in the initial exponential phase of Covid-19. As I derived above, once you get to 10% you might start seeing deviations from exponential in the SIR model. The bump that you saw in China is not due to this deviation from exponential growth behaviour. We luckily never got close to 10% infection. It's due to getting to negative exponential growth. The beta(t) part of my answer above.
You're free to use whatever sensible model you want in your analysis, but you are criticising people for using exponential models. You have no arguments for that. Then you throw out Wikipedia, falsely claiming that exponential models are nowhere to be found there. Then you demand peer reviewed studies that use an exponential model, which I provide. But somehow that is not enough either.
In fact there are numerous assumptions in the SIR/exponential growth model. These might not hold. We might get slightly sub-exponential growth in some diseases. There is vast literature on that. But the base line in all the vast literature on this is that the most natural, obvious and common behaviour is exponential.
> The rest is reporting crap written every time a new case was found somewhere.
This is the problem. Not that our institutions are failing to deal with the problem, but that our media has vastly overblown the whole situation in order to scare everyone witless so they'll keep clicking on news updates and watch those ads.
With the secondary effect, of course, that all searches for information end up at a media outlet trying to scare people, and not the appropriate primary source of suitable information.
And the tertiary effect that an institution presenting non-sensationalist data based on research is dismissed as an "inadequate response" if it doesn't match the hyperbolic media frenzy.
We should be shutting down newspapers, not schools.
People keep turning to the media because our institutional outlets provide inadequate information for the majority of the population. The institutions default to saying nothing useful because they are scared of blow-back.
I check my city, county, state, and world health sites and there is simply inadequate for my needs. I want to know what closures are in place in my community. I want to know if asymptomatic transmission is real. I want to know if there is a plan to widen the testing criteria.
That's the problem, yes. I still ignore the media, others don't. Both approaches are fine. The thing is, the media doesn't have any other sources, do they? But the have to produce content, so they do. Not very helpfull in the quality department if you ask me.
I would say that broadly speaking, media is better than the institutional outlets for providing information.
You have to sift through the garbage, but the content exits. to use the topics I listed above as an examples, I can find more details on local closures and outbreaks in the local news the local department of public health. Similarly, I have found coverage and links to medical journal publications embedded in articles. Lastly, the institutions are avoiding disclosure of next steps or plans like the plague ( no pun intended). Either they have no plan for the days to come, or they are intentionally withholding information. On the other hand, there are a number of media outlets, mostly non-traditional, that are providing projections based on other counties.
That is true and I agree. I would just point out that the unfortunate reality we live in is that the government sites are doing a terrible job of informing.
+1! And just to be sure, I would add social media.
But in all seriousness, I am absolutely disappointed with the reactions of Google, Facebook, Twitter and YouTube on this. Everybody made a well deserved fuzz about the 2016 US election. So these companies are absolutely aware of this. Now that the stakes are much higher. Still no response, no action.
What are you suggesting exactly? Do you want them to delete "alarmist" posts? That sounds like a recipe for a total collapse in trust in public institutions.
No, just giving the top search spots to updates from WHO, followed by the national, regional and local sources. Play with the search algorythm to push the more alarmist ones further down.
Help the above mentioned institutions to write their "content" in a social media optimized way. That would be agreat opportunity for these tech giants to gain trust they lost since 2016. Not doing anything right now moght very well have the opposite effect.
The WHO waited an extra month before declaring a pandemic, and US national sources are generally considered by experts to be understating the severity of the issue. What you want is the top slots to go to the experts, who are not necessarily ranked correspondingly to the hierarchy of political bodies. For example the top virologists are probably in labs and universities, not the Cabinet.
WHO has been shouting “take action now” the whole time and the official stance was “it could be stopped if governments act now.” Governments didn’t listen, so here we are. I fail to see what good declaring a month earlier would achieve, as governments clearly don’t give much of a crap about WHO advice unless the situation is seemingly spiraling out of control. One likely outcome of declaring one month earlier is being taken even less seriously; they can’t just re-emerge a month later and declare it’s really a pandemic this time.
That's why I didn't inlcude the cabinets, did I? Just in Germany, the relvant data comes from the WHO (global picture), Robert Koch Institut (national), state health ministries (regional) and community health authorities (locally). All are relevant, the international numbers show the large picture, inlcuding the declining cases in China. The national ones provide more detailed insights into the country in question, while the regional and local ones are the most actionable for you. Which schools are closed, which policies are in place and whay. Stuff like that.
I would prefer to not get these from some journalist writig his tenth article today.
Personally, I am also very cautious with virologists taking the cable news and talk show turs right now. Where are they taking the time from to do so? If they are spokes people from institutions, it is different. But if their function is "professor at university X", my gut feeling tells me that they might like the public attention a tad too much.
>But if their function is "professor at university X", my gut feeling tells me that they might like the public attention a tad too much.
This is a very interesting perspective, which is very different from my own. Being in the US, my attitude is that officials are usually chosen based on criteria other than their skills in the domain they are administrating, and I would expect the best knowledge on any subject to be found among low-level people who deal with it professionally. I am also suspicious that officials might prioritize maintaining public order over disseminating true information, which caused many unnecessary deaths during the Spanish Flu.
>I would prefer to not get these from some journalist writing his tenth article today.
That's true enough. But I would rather have information from front-line experts than administrative officials.
Second that, I would love to hear from the frontline guys. But I don't. It is either elected officials (fair enough, that's part of their job) using input from said experts.
You don't hear from the frontline people / orgs, I assume because the are simply too busy right now. Which brings me back to the professor acting basically as a free agent. That should change.
The professor is the front-line guy. I'm talking about epidemiologists, not physicists. If he wasn't acting as a "free agent," then you would be back to hearing from elected officials, who are mired in compromises and not entirely trustworthy.
if you think the WHO are not the best people to be dealing with this problem, that's a different problem than thinking that the WHO are not the best organisation to be dealing with this problem.
The WHO are literally the organisation we specify to deal with this problem. If they're staffed with the wrong people, that's a different problem.
I think it would have been terribly irresponsible to forcibly give the WHO top billing back when they were arguing nobody should restrict travel, or to suppress news of the preparations starting to take place in SV when official US authorities were universally saying it’s not a big deal.
Exactly. This. It's a Big Deal because of the media frenzy, not because of the inherent lethality or virality of the disease. We've seen similar pandemics before, without this media frenzy.
The WHO is making science-based responses, which are then perceived as "inadequate" by a public stoked into a frenzy by the media. The media are not motivated by public good, but by profit. The more scared you are, the more times you hit refresh.
We should definitely give WHO top billing on search results, because these are the people we've entrusted to do exactly the right thing in response to this situation. Giving top billing to profit-driven media companies is utterly irresponsible.
Or if we've got this wrong, then sack the WHO and appoint a half-dozen billionaires to their role. Same same.
This is because quality science is not correlated with good marketing, virality of media (bad word choice), or how people feel about scientific content. Most people are woefully uneducated in science and it's showing on the internet especially.
I think that this spreadsheet is communicating several things well but I share it as a "reasonable bad case back of the envelope calculation". And if we mean the same article, it actually does a reasonable job at outlining the uncertainties around testing and national differences, and focuses on what is probably the most robustly comparable data point we have: Number of confirmed deaths.
The problem with models used by experts is that they are diverse hard to parameterize and that the scientific conclusions drawn are based on many different models not on one.
Exactly why replacing by something simplistic doesn't fly. I'll go on a limb and say if I tried something similar in this guy's field, I would be destroyed for publishing it. And rightly so.
The post in question mostly presents observations about the base line models and data taken from reputable and cited sources. It didn't make up simplistic models on the fly. I would say it is breathless journalism.
I also would wish for better explanations from the scientists actively working on it. My first go to is RKI.
In my circles, it's one of the most discussed on the Recurse Zulip, it was shared by one of the Quakers on our Ministry committee (a college prof), and it was posted by one of the game developers I admire and follow on Twitter.
It does a good job of visual storytelling, the author obviously is good at being a "growth hacker," but it points to something deeply wrong when people are basing their decision-making on a document like this rather than communications from actual public health professionals.
I really don't think that changing one leader will change anything about the organization. In order to fix the situation you would have to understand their culture from the bottom up, see why they don't care about making models public (as far as I know this is the media's fault for not publicizing models they have already published, maybe the WHO is innocent), figure out what they needed to change, and then replace several leaders, being careful to only replace the ones that are part of the problem.
Doesn't seem very well thought out. The economic cost of the first scenario (numerous deaths in peak period) would likely be the highest with the impact both on workforce and market sentiment. The impact of long tail scenarios lower because death toll would not be just redistributed but also reduced by likely an order of magnitude.
No it's not. It's just one guy making up random shit on a blog and is pretending that governments think like him.
The reality is probably closer to the fact that there isn't anything governments can do about it. They can try to shut down the borders of the country, but that is going to a lot worse and probably won't stop it anyways.
Just because governments can do something and do do something doesn't mean that that something is meaningful or will have a positive impact.
The actions taken during February in Wuhan and neighboring provinces seem to have stopped the spread there, so effective actions can be taken.
Thing is, it appears that there's little overlap between actions that seem reasonable and actions that are effective. If you wait until drastic actions seem justifiable, then by that time it's too late to be effective (i.e. the Italy lockdown which would have helped Italy if it was done 2-3 weeks earlier); and if you take effective actions, then most people and media will wonder why you're so authorative and unreasonable (e.g. the reaction to early Wuhan containment measure enforcement).
Another interesting penalty of delayed action is that any exponential increase that happened while you were delaying needs to be balanced by a period of exponential decrease once you have measures in place. Exactly how much depends on assumptions, but e.g. delaying applying measures by 2 weeks could mean they need to be kept for 4 additional weeks.
So the overall cost picture is strongly in favor of early action.
Denmark did close every school and most administrations. France did not.
Many decisions can be taken, but are not (for various reasons). Most experts recommend to limit contacts rather than closing down borders, and no one is pretending to stop the virus but they all should try to flatten the curve. You don't seem to pay attention to the current situation.
Yeah, and we don't know the reasoning behind either decision. I can come up with maybe a hundred different parameters that could be relevant or not.
At this point we can trust authorities to have a reasonable approach to this and that they monitor the situation closely. Or we can assume they don't.
In the first case, we follow the action plan. In the latter we do what we can, best based on actions that worked elsewhere. Just complaining about how insufficient actions are in our eyes doesn't help.
Anyway, there plans for stuff like this government drawers everywhere. Ranging from school closures to plan keeping critical infrastructure up. Heritage from the cold war.
And even if the US federal government seems to screw up, states like New York and Washington seem to react rather decisively. And we shouldn't forget that things in China are calming down to an extent ad-hoc hospitals are closed down and medical supplies can be shipped to Italy.
Afaik in Germany the country's government can't force schools to close or public events to be cancelled. These decisions have to be taken locally (at state/city or even district level). All the health ministry can do is tell people "you shouldn't do A B C and you should do X Y Z"
In the places where they have shut down schools, they can't really do it either. But when government says "do X" and has good reasons, the institutions comply. I'm in the board of a private institution in a country with a shutdown order, and there was really no discussion between the board members that this institution would shut down too, despite there being no legal backing at all.
That seems to be exactly the reason in Germany. The federal government has no say regarding public gatherings or schools. They have given out recommendations, some have followed, others have not. There's no repercussion for cities not following the government's decision.
You can hide behind "I lack the legal authority" or you can act. This is one of the rare occasions that absolutely do call for the old "ask for forgiveness" mentality. Nobody in the lower tiers would complain about central government to take a very difficult decision off their plate. (some people will complain, those who still think they can just pretend that the epidemic does not happen, but they will complain anyways)
The difference is that, in China, if you don't comply the state security detains you and you get sentenced to re-education camp at best.
In other places there are no real consequences for you, even if people die. But there are legal and economic consequences if you shut down without top cover. That is why the government and legislative paralysis is so damaging -- with no safety net, people will prefer the unknown loss over the certain loss.
This is correct afaik, I'm pretty sure the decision to close schools is with the ministries of education of each German state, however if federal institutions put out strong recommendations, state and local administrators will likely follow very soon after. Federal ministries may not have absolute control here (unless they declare a state of emergency or something) but they do have plenty of influence.
Japan has a different culture. When the government puts out a "strong recommendation", the society generally follows. This even happens with corporations. There's a culture of conformity there that just isn't present in western nations.
a) There's a time-lag of probably 1-2 weeks between someone becoming infected, until their case hits the official statistics.
b) There will be different rates of testing between different areas, healthcare systems, and countries, which will be hard to quantify.
c) There will be fundamental differences between countries (e.g. patterns of population density, quality/availability of healthcare, etc.) which mean that direct per capita comparisons (as you made) are of little value.
Denmark's case number has increased far more than that of other countries in recent days. They probably had to act as they'd overtake Italy in less than a week with cases/capita if growth continues like that.
The case #'s only go up if you test more people. In Ohio for instance they are only testing very few people and there is now evidence of community spread because the 4th person confirmed had no known contact but you basically need to be in intensive car to get tested or have an obvious connection. So the case # in and of themselves could vary based upon testing criteria. Not sure if they have the same standards in Denmark vs France.
The fact that they refuse to do things like closing borders and immediately ceasing all travel by foreigners or citizens who've traveled traveled abroad meanwhile ending arbitrary social events is the reason you know it's hype up media nonsense.
Most of the actions taken are those most likely not affecting those in the target older or immuno-compromised demographic likely to have the serious consequences.
Shutting down borders helps if the virus hasn't reached your country.
If it has, there's no point in banning incoming people (maybe you can stop people from leaving so other regions don't get infected, but that's a less strong incentive). If you already have the virus in your country, the best thing you can do is slow its spreading, by banning large groups of people from congregating.
Has there every been a time when, "Country X can't do what country Y can, because X is too [big/small] while Y is [small/big]" has not been a useless comment?
Is there a generic term for this sort of fallacy, where someone brings up a random difference between [cities/states/countries] as an excuse for why one can't do what the other has already done, without ever bothering to explain why the difference matters?
It's even worse than useless. Giant states are often assumed to be much better than small states, because "efficiency". Yet, whenever actual conditions are examined, and (inevitably) small states turn out to be better for humans, we get this sort of "well of course smaller problems are easier to solve" apologia.
I mean, I'm sure in some cases being bigger or smaller is helpful. It just feels incredibly lazy, borderline disingenuous to throw it out there without bothering to connect the dots or analyze how size would matter in that specific case.
> small states turn out to be better for humans
Source/examples of this? In Europe, the larger countries like the UK, France, Germany, Italy, Spain don't seem obviously worse off to me than their smaller counterparts. Like if you compare the UK to Ireland, Germany to Austria, Spain to Portugal, etc.
How is it a useless comment? If you want to compare the actions of Denmark to France, it's more relevant to compare it to a particular region. Grand Est, for example has a similar population as Denmark.
This is almost common sense in the business world. No one thinks BigCo and LittleStartup are capable of the same things or that one's ability or inability to do something is equivalent.
Well, in that case, let's compare: the Grand Est region has about the same population as Denmark, slightly more COVID-19 cases than Denmark (587 vs 514), and more deaths (9 vs 0). And yet, most schools and the administration are still open.
For now. In business, people deciding on the very weak data basis we have to discuss we have, would rightfully be have their asses kicked. Yet, here we are, doing exactly this.
> there isn't anything governments can do about it.
Banning public events, locking down geographical areas, closing schools, pulling in retired medical workforce etc.
> doesn't mean that that something is meaningful or will have a positive impact
You can see the impact of measures such as enforcing lockdowns (e.g. Wuhan cases) and you can compare the spread of the virus in countries which take measures vs those that do not.
What? There is tons of stuff governments can do to flatten the curve. Educating people, closing schools, people gatherings, obligatory masks for all (or DIY bandanas), testing more.
States struggle to get enough masks for medical staff, diverting any for the general public doesn't seem smart. And self made masks will have so little effect that they could be detrimental if people decide to be less careful because they wear a masks.
To the other points, education about hand washing and behavior in public is the one thing governments have all done for weeks now. It just seems that this isn't nearly enough.
This mentality is just false. If more people of the general populous have masks, how does that not reduce transmission therefore flatten the curve?
Now I understand the logic behind there being shortages. But saying that the general populous shouldn't wear masks because it doesn't do anything doesn't sound accurate.
Without training it is very hard to wear PPE correctly. Even if you change masks regularly, it is hard not to touch the outside (hot side) of the mask with your hands. Reusing masks makes this even more likely.
Most people don't get a good fit of the mask either. Respirators are a bit easier but nowhere near enough of them.
Practically speaking all it does is burn through a small supply of masks.
> The reality is probably closer to the fact that there isn't anything governments can do about it.
They can proactively close schools, government jobs. They can roll out bailout programs to encourage business closings that would otherwise cause the businesses to go bankrupt. They can aggressively close borders, and enforce quarantines with military force. They can mandate the production of respirators, testing kits and other medical necessities.
Government can do A LOT that no other actor can, so I don't quite get where you're coming from with this statement.
Well, there is still no panic and hospitals are not overrun with patients. Russia is not China and far from being able to hide such things from public.
Yeah, the Russian government seems really trustworthy. /s You can depend on them to investigate the whistleblowers, who will mysteriously die from a sudden case of "community-acquired pneumonia".
Doctors in Russia are accusing the government of covering up its coronavirus outbreak and denying them protective equipment
>“While the whole world is facing an outbreak of a new coronavirus, Russia is facing an outbreak of a community-acquired pneumonia,” Vasilyeva said. “And as usual, we’re facing the lie of the authorities.”
>She said Russian authorities were referring to coronavirus cases as ordinary pneumonia, implying that they’re distinct from the coronavirus pandemic.
>Russian authorities strongly denied her claims. A statement from the Moscow Department of Health accused her of seeking “to discredit Russian medicine and relevant government agencies” and called for authorities to investigate her.
Coronavirus: Reported spike in pneumonia cases in Moscow as Russia accuses critics of fake news
>“I have a feeling they (the authorities) are lying to us,” said Anastasia Vasilyeva, head of Russia's Doctor's Alliance trade union.
>“I don't believe the coronavirus numbers,” said Ekaterina, a Moscow accountant. “I remember what they told us about Chernobyl at the time. It's only now that we're finding out what really happened.”
Not being able to hide things from the public has never kept Putin or Trump from lying through their teeth about anything.
The Moscow Times is currently reporting that there are 28 cases so far. We'll see how that turns out, regardless of whether they're currently telling the truth about it.
>"It's going to disappear. One day it's like a miracle, it will disappear," Trump said at the White House Thursday as the virus marched across Asia and Europe after US officials said the US should brace for severe disruption to everyday life.
>The President also warned that things could "get worse before it gets better," but he added it could "maybe go away. We'll see what happens. Nobody really knows."
It looks like a great cover up, which will be used if/when origins of virus will be traced back to RF. Such behavior is typical for RF. IMHO, it's better to watch actions of RF government and army. AFAIK, they already agitated some desperate Chinese, which lost someone they love, to spread virus at Evil West. They have plans to spread virus within Ukraine, as reported by Ukrainian intelligence agency. It looks like they have no fear of this virus and plan to use this situation for their advantage.
There’s a lot that governments can do. Ireland just closed schools and universities, and banned large indoor gatherings, for instance, and directed companies to make work from home available where possible (though this last one is really more a suggestion). This won’t get rid of the virus, but it may help to slow it and thus reduce deaths.
Closing borders, certainly at this point, seems largely futile.
I've read (true, who knows?) that in the USA this isn't legally possible. Federal government doesn't have that power.
This may be behind Trump's move to stop flights only to Europe, and not domestic flights. He has the power to do the former but not the latter, apparently.
It has everything to do with deflection, point out that the problem is over there, even though the virus is spreading inside already unchecked. The Governor of Ohio is putting an order to shut down all mass gatherings like sporting events and also suggesting people stay at home. Ohio State was closed before any cases where confirmed but it doesn't seem like other states are taking it as serious outside of California and Washington and testing is still only happening for cases that are in intensive care or had traveled still. So we have no idea what the true lay of the land is at this point.
If the internment of Japanese-American citizens during WW2 [1] was legally possible for the federal government, to me it would seem odd if cancelling Coachella wasn't.
The US courts have since explicitly rejected the reasoning used to justify the internment of Japanese-American citizens. It would not be legally possible today.
He's not just making shit up--the curves are reasonable. However, where he's very, very wrong is thinking that the government is deliberately waiting from T1 to T2. We don't have enough data to actually figure where T1, T2 and T3 are, and counting it in terms of known cases ensures you blow past T2. Look how fast Italy went from first infections to T3.
Govts CAN do plenty: close schools, theaters, offices, events, parades, mandate WfH, quarantine affected areas, distribute supplies, educate... there's a ton governments can do.
That's probably not the decision-making strategy of most governments, but it's a compelling POV for looking at the situation. Let it spread fast, wreak havoc and disrupt the social order, or control it within the capacity of health systems, or try to minimise the infections with constant awareness of the society for a prolonged period of time, affecting the economy in the long run.
>The economic cost of the first scenario (numerous deaths in peak period) would likely be the highest with the impact
This is self-evident, both due to first-order and second-order effects. How the author manages to stand it on its head is amazing. It's worth noting that approaching, or exceeding, the capacity of the medical system (or any other) drives the costs sky high by and of itself - not to mention other, unrelated cases that also need treatment. With a few weeks worth of disruption to healthcare, even mild cases of other illnesses can spiral out of control and become costly (or even deadly) on their own.
I wouldn't read too much into a country having a muted or slow response to the pandemic; it's the expected outcome of political and economical systems differing across the globe. There is always a slow country to act, and its citizens might feel entitled to the kind of far-fetched speculation the author posted.
> There is always the slowest country to act, and its citizens would feel entitled to the kind of far-fetched speculation the author posted.
Sounds about right. Belgium and the Netherlands aren't doing very much yet.
One interesting fact I discovered when discussing with my wife last night that I think does shape the discussion here: In the Netherlands, seasonal influenza has ~1% mortality rate -- in the U.S. it's more like 0.1%. This leads to different framings of the comparative severity of Coronavirus in the Netherlands.
>In the Netherlands, seasonal influenza has ~1% mortality rate -- in the U.S. it's more like 0.1%
Completely false, it seems 0.1% also in the Netherlands.
"In the Netherlands, our closest comparisons are the Mexican flu of 2009/2010, with a mortality rate of just 0.02%, and the regular flu epidemics, with an average mortality rate of 0.1%"
from:
https://healthcare-in-europe.com/en/news/on-the-implications...
>In the Netherlands, seasonal influenza has ~1% mortality rate -- in the U.S. it's more like 0.1%.
(I'm not a healthcare professional nor actuarian; the following is freehand speculation)
There are two key factors. Firstly, USA is much less densely populated, with various additional compounding aspects: social stratification, with many segments of society living mostly in their own areas, and lesser dependence on mass transport. Modern technology and abundance of land allows maintaining a degree of isolation when needed.
Secondly, the healthcare system in USA vs Netherlands is tale of semi-private vs nationalized system. The former has more incentives to be proactive and minimize costs, vs the later having incentives to make a good showing, with payments being assured anyway.
> The former has more incentives to be proactive and minimize costs
On an individual basis perhaps in theory, but not on a population basis. See underinsured people afraid to go to a doctor until their condition is so bad it warrants an ER visit.
The actual numbers of the cost-effectiveness of US healthcare also shows the complete opposite of "minimizing costs" where it's twice as expensive as any other system
I don't know, but I live in the Netherlands (as an expat) and their approach to healthcare is legendary for its sloppiness. The most common joke is about doctors responding to any health complaint by handing some paracetamol and saying "come back in two weeks if you don't feel better".
Three days ago the government held a special meeting about the coronavirus, in which they deliberated that people should stop shaking hands. That's all. They tell people who have come back from a high risk area and have flu symptoms NOT to call their gp and just stay home.
I'm not saying healthcare is bad ("sloppiness" wasn't a good choice of a term). In fact it's very well organised.
It's more that the Dutch seem to be extremely... relaxed, maybe a bit fatalistic, about illness. It's a "suck it up" attitude. The fact that they're so slow in taking action now doesn't surprise me.
Maybe cultural. One of the reasons I love working with the Dutch is their calm professional approach to things. Not the worst trait to have in times of crisis.
The outcome may sound dystopian. But once you put monetary value on a life - I think insurances do around a few million per person - then the economic damage will be worth several lives anyway no matter which scenario you choose. And that kind of calculation does make sense because at some point economic damage starts to translate directly to deaths, at the latest when your food and medical supply collapses, probably sooner than that. So you end up trading some deaths for other deaths.
Of course I'm not saying that anyone has done those tradeoffs optimally, especially considering that those relations probably are non-linear in practice.
But we are nowhere near that point. Issue some Fiat money to businesses most heavily impacted. Reduce the spread of the virus. Save lives. Worry about the money later.
It is worse than that - a dystopia is a result of humanity's folly. It being favored is a sad inherent result of "evolutionary" systems where it isn't what is more than what is morally right or wrong much less optimal. It rests upon one dumb tautology: All other things equal things which perpetuate spread more than things that do not. The process while producing quite a bit of emergent complexity is fundamentally dumb.
Self perpetuation is fundamentally based only on the implications of the strategy. If keeping elders alive past nominal utility helps spread well then it is effectively favored. Which may or may not be known ahead of time.
That said by being smarter than it we have both the ability and responsibility for the consequences for decisions to follow or defy its nudges as we can and see fit.
Not aimed at you, but, I am disgusted at even a mention of these kind of 'calculations'.
And yes, I am prepared to take a hit in my earnings, paying higher taxes if needed after this if that is what it takes for at least one person more to live.
Another way of thinking about it is that there are other non-coronavirus interventions you can perform that will convert money into lives. if you spend money performing coronavirus interventions then you retard your ability to perform these other interventions that might be more efficient at converting money into lives.
Every second you spend on HN instead of moonlighting for extra cash to donate (it goes without saying you already donate your salary beyond what's required for subsistence) is frankly disgusting to me. You're murdering by the second.
What? This has nothing to do with the slippery slope fallacy. . It's not because we're aren't there yet that saying that it could happen is a fallacy. With that logic any type of planning or forecast about the virus is just a slippery slope since we aren't there. And If you agree that forecasts about the virus are okay, I dont see why forecasts about the economy depending on what policy is enforced (full isolation that would ruin the economy or allow people to get infected to keep it going) are worst?
Because grandparent said they would sacrifice a realistic tax increase to save lives in the COVID-19 outbreak, the parent asked about a confiscatory 99% tax rate and asset seizure, which would be wholly unnecessary for paying for the current crisis.
Yes, current crisis. Everyone agrees on the fact that the virus will probably spread and become much more widespread. Isn't it logical that costs will go up too, especially if the state decides that the economy isn't worth the loss of lives? Is slippery slope just saying that cause and effect exist now?
I don't see how the original comment was unreasonable in asking what is the threshold where economic losses are too high. Halting all economic activity to completely stop the spread of the disease and prevent deaths amounts to a 100% taxation since you are forced to not work and generate revenue. Whether that is acceptable or not isn't my point, but asking the question isn't a fallacy
You guys missed the point of my post. GP was saying that he found it reprehensible to make calculations on human life. My point was that he had already made such a calculation, implicitly. The value of a stranger to him is exactly worth however % income decrease he's willing to take + % increase in tax. Everyone makes this calculation every day.
Even in the red scenario, the number of people who will end up sick for a long time and require a lot of care outnumbers the death toll.
Caring well is always better than not caring. Unless we won't care in the green scenario either. But then, who think we won't care if we have time and resources?
This may explain why sexually-transmitted diseases get so much attention. They're probably the only kind of diseases that hit younger population much harder than senior citizens. THOSE are the diseases that make the rich earn less money.
From an ethical point of view, governments owe seniors the money and care, because they had worked for state prosperity. Also, if young people had more foresight, they would realize the way seniors are treated today will be more less the way they themselves will be treated. But old age and death is a depressing topic and no one likes to dwell on it.
> This may explain why sexually-transmitted diseases get so much attention.
At least in my country, we spend radically more per-capita on healthcare for the old than we do for the young [1] simply because the old need more of it.
For men age 5-45 we spend less than £1000, for men age 80-85 we spend more than £4500. It's a similar story for women, but with a bump for women of childbearing age.
I don't see any evidence of a bias in favour of the working-age population.
As with many things, there are two ways of looking at this. One is that old people need it the most. Another is that helping younger people is more cost-effective because they have more life ahead of them and if you cure them they're unlikely to get another disease soon. The latter is more heartless, but you can't deny there's some merit to it.
"This may explain why sexually-transmitted diseases get so much attention. They're probably the only kind of diseases that hit younger population much harder than senior citizens. THOSE are the diseases that make the rich earn less money."
This seems implausible to me. Given that the rich tend to be of rather old age themselves, I'd wager that they'd invest in preventing their own deaths
Of course it's true, but do we want to live in a society where we prioritize economic output over the life of people? Many do not and governments were elected by those.
> The economic cost of the first scenario (numerous deaths in peak period) would likely be the highest with the impact both on workforce and market sentiment
The deaths from Coronavirus are mostly not people of working age. The death rate for 50-59 is around 1%, below that it drops to 0.2%. For seniors it's as high as 20%.
If you want to be cold-blooded about it, there is certainly a case to be made for shrugging and plowing on, as that will minimize the duration of the impact (quarantines, etc) and the people who will die are mostly not economically productive.
To be even more crass - before long we will probably be in a triage situation where there are more cases than resources available to treat. There are only about 20 full-service respirators per 100k people, around 62k nationwide, and many of those are already in use (people will still get in car accidents, have strokes, get meningitis, whatever). We can't treat everybody. So who gets it? Little Timmy who has a long and productive life ahead of him, or great-aunt Susan who's 75 and barely gets around anymore?
At a first approximation there will be around 100 times as many seniors who need treatment as youngs. From a social perspective it's pretty obvious that treatment should be prioritized for those younger patients.
(reminder that not making a choice is still making a choice, whether that means treatment ends up being first-come first-serve or a financial/insurance basis. Triage sucks, but you have to prioritize your resources somehow or other, the whole problem is there is not enough treatment to go around.)
This is just not correct. Governments are acting on this throughout the world. Don't conflate governments with politicians. For well-functioning states, state agencies are dealing with this through well-established protocols that don't need political clearence. This means that the countries where politicians are the most visible and calling for action could very well be the ones that have prepared the least.
Exactly. In many countries it's down to the city or county to act and federal government can only take over as last resort. We're not there yet. Not all cities are equipped equally and it's frustrating that they don't have a common policy but they all seem to act. For them that's also the first time they are confronted with a pandemic and there's a lot at stake. Under these circumstances, I'm actually somewhat surprised how quickly certain policies are enacted around the globe. A week ago, banning large public events was a novelty, now they're basically banned in most of Europe and parts of the US.
The quarantine in Italy seemed extreme a week ago, now several countries are heading towards the same measures.
In democracies, curtailing peoples' rights is always tricky, it's the first time I've seen bureaucrats take away individual rights daily without backtracking on decisions.
This is even more obvious when you consider what the economically-optimal thing to do would be: Shut down nonessential travel to other countries and enact quarantine protocols for essential travel between countries, before you have community transmission. Then test heavily, for cheap.
Trump shut down travel just as doing so became pointless, the USA is barely testing people, and the CDC is resisting drive-through test centres because they are (actual quote) “trying to maintain the relationship between individuals and their healthcare providers.”
I think it's a different reason. Let's analyze the outcomes from game theory perspective, along two dimensions: virus becomes pandemic or not, and governments do something or nothing.
1) no pandemic, no action -> government was "right", avoided wasting money -> reelected
2) no pandemic, action -> government was "wrong", wasted a lot of money, damaged the economy, inconvenienced the lives of the population -> voted out
3) pandemic, no action -> government was "wrong", caused loss of lives and damaged the economy -> voted out
4) pandemic, action - this is the trickiest scenario, so let's consider two options:
4a) pandemic, action, it works -> government was "right", saved lives, spared the economy -> reelected
4b) pandemic, action, doesn't work -> government was "wrong", their actions failed, they're incompetent -> voted out
There's two winning scenarios, (1) and (4a), but the problem is that (4a) has vanishingly small probability of success... with little information available about the virus, and rampant globalization, it's hard to know what action makes sense, is correct and viable... Case in point is Italy, which did act in time (they banned flights from China 2 weeks before the outbreak), but still failed (i.e. their action was "correct" but not "correct enough") because their neighboring countries (e.g. Germany - not technically a neighbor but within Schengen Zone) failed to act.
So, politicians choose (1), no action, as the most likely winning scenario.
> So, politicians choose (1), no action, as the most likely winning scenario.
I'm from Belgium myself, so I can chime in.
Our minister of health is a docter herself, and is advised by a panel of experts including a professor of virology. They know very well what they are doing with the current 400 known infections.
Closing schools makes no sense currently because of following factors:
- kids are not the main factor in spreading the virus, as seen in other countries.
- Putting kids with their grandparents is probaly worse for death toll compared to keeping them in schools.
Closing schools makes senses in democratic nations for two reasons.
First, it puts societal pressure on businesses to close or modify their operations by allowing people to work from home. Many families are simply not setup to have kids at home, but parents at work, so factoring that in will cause businesses to change.
Most importantly, all this happens without government directly intervening in business decisions.
Secondly, it lays the groundwork for politicians to take more drastic actions. If schools remain open, even if it makes sense by “the numbers”, it’s still going to be politically difficult to cancel events, restrict general travel, and eventually close businesses. The public sees school closures as step 1 in any disaster situation. You can’t discount the importance of emotional signaling.
Maybe, but this is not linear growth. It's still exponential, albeit not as steep as ours (Slovenia), but you are still on course to double number of cases every 5 days.
Linear growth would have a declining rate for daily percentage change (adding 10 cases when you have 100 is 10% change, adding 10 when you have 400 is 2.5%).
What have Belgium and Denmark done differently, up to ~10 March?
I don't see much (if any) difference in their responses, so there must be some other factor for Denmark -- e.g. increased travel to Italy, more tourism from China, poorer personal hygiene, ... I don't really know, but
Your comment is fine except for that attack. Please don't stoop to that here, regardless of how strongly emotions are running. It helps no one and only makes this place worse.
First, there's no "no pandemic" case. Not anymore.
Second, your conclusion says that "politicians choose (1)" but that is not the case at all - almost every country in Europe, Asia, middle east had taken measures, with varying severity, and significant economic cost.
Last but not least, the whole framing is extremely simplistic and follows the "politicians are evil" reddit-like logic.
> First, there's no "no pandemic" case. Not anymore.
I am not saying that the analysis is correct, but information that is disclosed now has no bearing on an explanation of the actions of actors in the past.
> Last but not least, the whole framing is extremely simplistic and follows the "politicians are evil" reddit-like logic.
Politicians are people who happen to really care about being reelected. If you have any contact with them, you will realize that this is the ulterior motive of all of their actions. In a sense, as it should be. Being our democratic-elected representatives, it seems reasonable to me that they behave as slaves to the preferences of those who elected them. Like everything else, this creates a bunch of perverse incentives. You would have to be very naive to overlook these things, and imagine that powerful politicians will no put reelection above all things. The ones that didn't did not get reelected, and are not powerful politicians.
The original post probably uses pandemic in the colloquial sense, not by the WHOs definition which seems widely disagreed on. Remember the last WHO pandemic was the swine flu, which turned out to be more mild than the seasonal flu.
I would say it follows a "politicians act in their own best interest" logic. People with jobs in other industries have similar behavior, but I suppose the politicians have greater impact on society, so most people rally around the cynical view of politicians.
Besides, it's a lose/lose proposition for the gov anyway.
If they do act, people will blame them for the cost of the action.
If they don't, people will blame then for the cost of not acting.
Nobody will pat them on the back, except a few intellectuals, for acting.
In fact, economically, the virus spreading is an opportunity to fire people you couldn't fire before, get rid of an old population costing money and have an excuse for a lot of things like passing certain types of law. People will not focus on that, their attention is elsewhere, and you can always invoke the circumstances if they do.
We have created a system in which it's not in the interest of the gov to solve the problem. And in which the population lives in a way that makes it hard to do the right thing by themselves.
More accurately, I think, we have let very cynical people take control of everything important. So in matters of policy it's reasonable to assume extreme cynicism.
The natural human instinct is to look to leadership during a crisis. This is why Bush’s competency in the eyes of the public was harmed after Katrina. This is why McCain’s “maverick” rep harmed him against “steady” Obama during the financial crisis.
If the coronavirus starts impacting the lives of Americans in a widespread manner (shuddered schools, closed offices, loss of jobs), the same instinct will kick in.
Given what the current POTUS has gotten away with, as with many others in power everywhere, I don't have much faith in the accountability we can expect.
The economy is going to be in shock, whatever you do.
Don't act, and you'll get a messup economy because of the panic and the sick people.
Act, and you'll get a messup economy because of the panic and the sick people, and the cost of tests+quarantines+curfew. Less people dead is the ethic thing to do, but power is not about morality.
This comment is a perfect example why we won't have the same containment as Japan or South Korea; we in the west, "know" that our government is evil/incompetent/selfish so even if they act, we will not heed their advice.
It's not like they don't have the same incentives in the other countries, the main difference is that we do not trust the government. Might be selection bias, but I do think we have been hammered with a stereotype on modern culture about the incompetent/evil bureaucrat getting in the way of the hero's solution.
At the risk of being down-voted, I'm not trying to start a political debate. I'd just like to know, as someone outside the USA, how this is affecting the election campaigns there.
Are personal costs of the pandemic encouraging people to support subsidised healthcare, and therefore a left-wing party?
Or is the xenophobic rhetoric of "blame China/Europe/travellers/etc" causing people to support a right-wing party?
I also haven't seen a full discussion of the chain of cause and effect. There was a shift from the primary sector to tertiary services, which led to urbanisation to find demand for services. Young people living in cities can make more friends than before, and this is good! It also means that there are more people living in close quarters, who can spread disease more effectively. I'm willing to face the risks of urban life instead of subsistence farming, but I wonder if other generations resent that.
I see a lot of what you mention on online mediums.
But it's usually quite different than what's really happening IRL.
People love to play the panic game online, but I've seen only quiet order around me.
Yesterday, my entire neighborhood has been evacuated because of a bomb, we were all grouped in an hospital, where we were questioned about possible fever.
In airports, I see people wearing masks, facing cancelled flights. I see stores with huge queues to buy stock of food.
It all happens in a calm and civil manner.
Maybe I'm optimistic, but I'm nicely surprised by the way people act right now, despite all the blame we want to place.
The long term impact on U.S. politics is hard to gauge. As a member of the Democratic party, I am in favor of emergency legislation that provides direct financial payments to impacted individuals. In particular, we have close to 30 million uninsured and they have a strong disincentive to get tested for Conrna virus due to unexpected/unknown costs.
This is likely the same segment of the population who have a strong incentive to go to work ignoring risks of community spread. They live pay check to pay check and can't afford to be sick and take time off.
As an emergency measure, the federal government should carry all costs associated with virus testing. Any individual who is quarantined or must stay home to care for those quarantined should receive direct cash transfers to off-set the immediate economic dislocations this causes.
The current federal administration's argument for suspending payroll taxes does nothing for those who are unemployed or work in the informal, cash economy.
Luckily, at the state and local level officials appear more competent placing the health related impacts above politics. As an example, the governor of New York took the unprecedented step of quarantining New Rochelle just outside New York city.
If there is any possibility of a silver lining from all of this, it would be how the U.S. electorate might see the true economic cost of allowing roughly 10% of the population to be uninsured. To me, it is immoral that the richest nation on earth permits those who are most vulnerable not having equal access to adequate healthcare.
Finally, as an indication of how the federal government continues to politicize the pandemic, the Secretary of State continues to call the Covid-19 pandemic, Wuhan virus, as an insult to China.
As a US citizen lucky enough to not be significantly impacted by all of this, I'm deeply embarrassed by such an outrageous insult from a federal official.
I don't know the answer to your question, but in addition to the mechanisms you mention there's at least one more: there's some evidence that fear in general, and fear of death in particular, tends to make people more supportive of right-wing authoritarian government.
(I don't mean to imply that right-wing = authoritarian; I pair them together because my recollection is that the research in question was specifically about right-wing authoritarianism and not about rightism generally or authoritarianism generally.)
So (1) to whatever extent the GOP is authoritarian as well as right-wing, or at least pushes the same psychological buttons that authoritarian rightists do, it might benefit from having a population that feels afraid, and (2) maybe Mr Trump would have done better politically with something along the lines of "This is a deadly epidemic, sweeping in from scary foreign countries, and only your strong President can protect you and keep you safe". I guess the restriction on air travel from Europe may be intended as a bit of a pivot in that direction.
I doubt it will affect elections directly. Looking around the world, there's mostly bad examples from all kinds of governments - right-wing (Trump in US, Johnson in the UK), centrist (Macron in France, Merkel in Germany), left-wing (Slovenia - was centre-left until a week ago, Denmark), totalitarian (Iran, China)...
Most people do not see any personal cost of healthcare and thus are not turning more left-wing. The left-wing party is pushing that view, but they are not changing anybodies mind.
There’s not much right vs left yet. It’s just the Democrats figuring out who their candidate will be. The pandemic has a very small effect on the US right now. Things are closing but mostly in anticipation of the near future. Almost none of it is in the middle where the right lives.
There’s been some yelling at trump over his poor handling but it’s mostly just virtue signaling at this point. When the elections come around for real we will probably see something of this if/when it has evolved into something more serious here.
I say this in Boston, just a few degrees of separation from some of the COVID confirmed individuals.
> (i.e. their action was "correct" but not "correct enough") because their neighboring countries (e.g. Germany - not technically a neighbor but within Schengen Zone) failed to act.
The Italian cluster most likely stems from an initial infection in Germany which occurred 10 days before the first flight bans anywhere. Italy probably failed, because it reduced testing to only include symptomatic cases at a critical time ( https://www.adnkronos.com/fatti/cronaca/2020/02/27/coronavir... ), not because Germany did not disallow flights at a time where it was already community spreading in Europe.
> 4a) pandemic, action, it works -> government was "right", saved lives, spared the economy -> reelected
This is too optimistic. If it works then people see a tiny death rate and a shutdown forced by the government. The greatest success will look like an overreaction.
Yeah I'm not so sure. In Poland the actions are on the "extreme" side so far, and not many people complain, because sights and news from Italy are constantly brought up as comparison. It's constantly "unless we want to be as screwed as Italy is, we need to do X" and not many people complain about X.
Same in Lithuania. Closing schools, clubs, gyms, canceling all public events and gatherings. So far we have only three confirmed cases (all came back from Italy), but the public is mostly supportive("finally!"). And that is even our health minister is at the bottom of the popularity rankings and the current goverment is not loved at all.
Yes, this is y2k/ozone hole syndrome. Arguably financial crisis, too; that would have been a lot worse without the quite extreme government intervention round the world, but it generally didn’t work out well for the politicians involved.
That said, a lot of governments are taking serious measures and apparently not counting the electoral cost.
Yes, unless your govt is hyper-nationalist and labels the pandemic as a "foreign virus". (Of course dirty foreigners are going to get sick—They're dirty.) We have no fear of pandemics here. We're superior. God protects us. Except for our non-conforming neighbors. They're rat-infested slums, so of course they will get the foreign virus too. God will protect us in our region though because we're clean and white, and we support the hyper-nationalist worldview of Dear Leader.
So it's a complicated problem, with many dynamics at play.
But all their experts have been telling them that (1) cannot happen, for quite some time.
Another explanation is that government don't realize how much their words and actions have an effect on people's behavior, or they only focus on the worst possible effects ("what if people don't understand or react badly?"). In which case, they downplay the danger only to delay their decision. Because they're afraid of themselves (and can't have trust in the population).
> But all their experts have been telling them that (1) cannot happen, for quite some time.
No, the experts are subject to the same game-theoretic play... e.g. WHO declared it a pandemic only yesterday. The only ones who suggested the correct action (ban all flights from China already during Chinese New Year) are the ones with no skin in the game / no decision-making power / no relevance, who are therefore not subject to the game.
The idea of dividing the outcome up into two binary "it works" and "it doesn't work" is a logical fallacy. It's like the ridiculous anti-gun control arguments that say because a measure doesn't stop 100% of gun deaths, it's not worth doing at all.
That's now how game theory works, the pandemic is not another player who is 2nd guessing the government or vice versa.
Instead governments are weighing the probabilities (think a probability tree, according to your scenarios) you kind of point to this in your conclusion.
The point of Game Theory is to analyze the situation according to the actual payoff function for each player, not according to the socially (Pareto) optimal outcome.
The 2 players here are the government, and the voters. The socially optimal scenario is action REGARDLESS of whether it's a pandemic or not (in a hyper-globalized world it would hurt a bit, but only the first time, after that the tourists, supply chains, etc. would adapt) but the voters penalize that outcome (they see action with no pandemic as overreaction not as successful prevention) so governments avoid it.
The question here is which actions of what severity, not simple act or not.
There are many ways to handle this, from maximum quarantine and cancellation of medical appointments, through closing mass gatherings (e.g. schools), rationing, enforced testing, closing public transportation, controlling private transportation, closing airports, sea and river ports, mandatory sampling for tests etc.
Each choice comes with a value for disruption and voter groups it will affect, and value for monetary cost.
Game theory is not too helpful here, as disruption does not directly affect discontent and definitely not your chances of getting elected. These are much more complex decisions with many more actions between here and then.
It still isn't game theory, the government acts first, the voters act after after observing the outcome. There is no subsequent game.
It is simply up to the government to estimate probability and expected payoff. Optimal action for government is to take the least amount of action to prevent the voters from thinking its a pandemic. It isn't a game theory scenario, there are no nash equilibria.
Does Japan include the cruise ship? Don't forget, Germany is a major transit country in Europe, everybody traveling back from Italy to the North crossed through. Italy, and the Alps im general, are in the skiing season. So a lot of tourism going on. Plus, 200 to 1,600 in 8 days isn't nearly as bad as you make it sound.
Just that the majority if governments in Europe are taking steps, pretty radical ones at that. For no other pandemic, SARS, MERS, various flus or Ebola was anything even near to what's done now.
I wouldn't like to be the one to meet the decision, so. Because the cost of closing down a country for a couple of weeks is enormous. So when do put these actions in place? I have no idea, but it seems to be pretty difficult to get the timing right.
There is no point in crying wolf over these actions online, or even worse about what should have been done in hindsight. There are whole staffs doing nothing else right now, experts in their respective fields. So the best we, as a public, can do right now is to get out of these people's way. We follow guidelines like washing hands and reducing contact. We go self quarantine. We take steps we can in our social and professional environment. We send our employees into WFH or close certain cites if that's not possible. We work with authorities to come up with plans and contingencies if our companies are relevant in that regard.
But banning direct flights from Italy was definitely not the right action especially since the tourists were just rerouted through other European airports. All the epidimiologists are saying that closing borders doesn't help since the beginning
But there is obviously a pandemic. I mean the WHO just called it a pandemic. How is 1) even an option? Do they just pretend it doesn't exist? Do they hope it doesn't kill too many people? People wont buy it, that's for sure.
> Italy, which did act in time, but still failed because their neighboring countries (e.g. Germany - not technically a neighbor but within Schengen Zone) failed to act
This is incorrect. Italy closed borders on Jan 31st. The Chinese visitor to the Webasto company meeting came to Germany on Jan 19th.
It is easily evident that Germany closing its borders at the same time as Italy would not have prevented this transmission. You should probably increase your skepticism about the media where you read this.
This may be true if politicians are selfishly focused on reelection, and it’s one of the core reasons western democracies have term limits.
In times of crisis our system needs leaders who do the right thing over the popular thing, even when it means risking losing office. This is called statesmanship.
Voters would do well to remember this when choosing leaders, it’s an increasingly rare quality we select for.
The president may have term limit but the party might want to continue to be in control of the senate and congress (or the equivalent in other countries)
After Y2K I tried to raise this point that all the work did pay off. I guess people were expecting a control case somewhere, like a random power station in the middle of nowhere crashing, to show what happens if a system remained unpatched. After a while, I started to doubt myself as well. Even going to "Y2k was a hoax", for a brief period. But talking to more programmers from that period snapped me out of it.
Even supposing politicians all act 100% selfishly, they'd still want to do everything possible to mitigate the effects of the pandemic: for themselves and their own families, even if for nobody else.
So, they want to hole up, then let the pandemic burn to completion as quickly as possible, so they can then emerge. They want everyone else to be exposed so they are no longer dangerous (either dead or immune).
This analysis could just as well be applied to "war on terror" -- The response to which was opposite, and a lot of people profited by it (careers, contracts, etc). What makes them different?
Wait, been I've been told "you can't just shut down travel", and that closing borders doesn't work, for reasons that are completely self-evident. So I'm utterly mystified that there are virtually no cases and 0 deaths in countries like Russia and Mongolia that closed their borders.
I think we should not attribute to malice what we can explain by not being able to get your sht together. Belgium did't have a government for a very long time because they couldn't get the sht together. I think they are just overwhelmed and scared.
Not attributing it to malice is white-washing, after Steven Miller or somebody equally racist ordered an immigration judge Christopher Santoro to issue an order to take down all Spanish Coronavirus prevention posters from immigration courts. In their way of thinking, the more immigrants who get the virus, the more Trump can say "I told you so" about his border wall. It's biological warfare, in support of a lie.
That and giving smallpox-infested blankets to Native Americans was 100% genocidal malice, not a lack of having their shit together. The problem is that they DO have their shit together, and it's racist xenophobic mendacious destructive shit.
The Trump DOJ’s Crazy Back-and-Forth on Coronavirus Prevention Posters
Had an interesting thought earlier. Seeing as a majority of deaths are in the range 60 years and above, and very little of the casualties affect younger (working) people, from the governments POV the virus will do well to decrease the disproportionate number of older pension receivers and nursing home residents in comparison with the dwindling number of young people working and paying taxes.
In other words, the government probably realizes that despite the grim reality, their POV may be that the virus will have a net positive effect on the economy and also accommodation affordability for the younger generation.
>their POV may be that the virus will have a net positive effect on the economy and also accommodation affordability for the younger generation.
Stressing systems like that is far more damaging/costly than managing the situation with care. Even if the death toll for the elderly explodes, there will be far more more old people requiring intensive care over time. Don't look at the death tool only, the coronavirus does not "kill clean".
You assume that the government cares about expenditures. Old people vote. So it would be in your best interest to keep the people that voted you into office alive.
I second this. Because of this I don't understand why the German government is not acting more drastically in terms of isolating old people. Especially the current CDU/CSU/SPD leadership was largely voted by the elderly.
More likely. People will see the government is ineffective. This raises questions on why have one at all. Some citizens stop paying taxes because of it. This turns into an actual movement because of compelling arguments now with evidence. Government becomes insolvent and wipes out the bond market. Inflation spirals and a full panic begins.
Last Sunday it was 8th of March, International Women's Day, and the current spanish government has appropriated it to the point that women from other political parties are not welcomed in the protests that happen that day.
When gatherings of people started to be canceled all around the world, the government kept going ahead with the plans because this is a key event for their agenda.
The very next day, they acknowledged that the virus is out of control in several regions in Spain, started to take very aggressive measures that are only increasing each day.
Today, it has been announced that Irene Montero, head of the women rights ministry, that lead the main protest that day, has tested positive for coronavirus.
The saddest truth is perhaps that functionally, we have the leaders we deserve.
It's a simple projection from voter space to elected space. As a former pol.sci. student/researcher, I've grown disillusioned by the fact that representative democracy, in our day and age, quite evidently no longer works as intended — the projection is flawed with regards to the conduct of affairs.
I don't know why:
- might be that voting is skewed by marketing (permanent campaign) money, government is too corrupt and establishment too entrenched, the "conspiracy hidden in plain sight / normalcy" idea;
- could be that democracy simply doesn't work as a system, or maybe not anymore, because the "average" is somehow not good enough — that was certainly not my belief, not for a decade, but I had to come to terms: it's a question worth asking, I assure you. Just considering the quality of information and the noise/signal ratio throws a huge wrench in the mechanics of any sane decision-making process...
- ... (many more hypotheses)
Regardless, this may help us craft the next-new-better political system, which might or might not be a regime of increased freedom compared to now (my guess: much more in some domains, much less in others, and not everyone will like the distribution).
I mean, look where we are. We had 15 years to get ready for such an event since coronavirus of the 2000's — tons of reports and words of good will. “Guys, we're not ready for a massive outbreak!” — everybody and their Bill Gates said so! But alas, the political fantasy kept going and it's all been just words. It wasn't that hard to stockpile masks and various supplies for when the day comes...
It's a sad day in history when we must face the consequences of our choices, but it's like a cycle... We get too complacent and something slams us, again and again and again (give it 3-4 generations apart to "forget", it's as if written language doesn't exist).
I'm jaded at the irony of our collective behavior, and sad for all those who will suffer and leave. Hopefully this will be a painful but learning experience that will last. I'm sad to report that it almost exclusively takes real pain, real hurt for societies to learn anything meaningfully in the face of history, of evolution. So, here we are, destiny.
> The saddest truth is perhaps that functionally, we have the leaders we deserve.
The public at large are terrible bosses. We're disengaged and bad at measuring what our employees (leaders) do, so style trumps substance and it's hard for us to tell if any of them have a measurable impact.
We have little ability to get to the truth of what's going on and are deliberately dissuaded from this with huge omnibus bills and whatnot. News has become about narratives instead of substance, with hardly anyone caring to look at the underlying evidence of anything, letting liars get away with so much.
We constantly raise standards with no way of enforcing them. Naturally, cheating is the only way to appear perfect, driving out very good but imperfect people in favor of massive liars who cheat. We're also not good at holding anyone in politics to account. Everyone knows that Jeffrey Epstein did not kill himself, but only some low level guards will be held to account for it most likely. The general public has no idea what to do and the leaders are too happy to sweep it under the rug.
So you're probably right, we have the leaders we deserve in some sense. The general public makes for terrible bosses, which is probably why too many people work under bad ones.
That's true and I'm certainly not advocating for dictatorship. There is a vast space of possible regimes and political systems in between total freedom and total slavery, though... ;-)
Look, I won't pretend having "the" solution because it doesn't exist until we actually implement something, then iterate our way into a more-or-less final form that works. That's how we went from absolute monarchy to representative democracy, but if you trace the roots of that process, you've got a solid century of experimentation and much, much thinking (pretty much all the great names you know from 15th-16th-17th century were on some side of that equation, informed the discussion and ultimate "object", regime, that appeared).
So what will it be? Well I could write some anticipation sci-fi to suggest possibilities that are non-dystopian (well, not so much that it's unbearable) and come with a ton of benefits, and obviously some drawbacks / limits / undesirable side effects to be managed, adjusted.
The question is what the political will of the People actually wants— it's a question we each have to answer for ourselves —and what is possible, without breaking the machine, what will be desired, refused or simply ignored by 'elites' who, like it or not, have the fuel to make-or-break such 'evolution'. Now add an 'r' to the word and you increase the range of possibilities, but risk as well.
Here is my personal feeling: I think such events as COVID-19 will spark the kind of seed that eventually grows to fundamental political change; I however think we're still half a generation away from that — give time for Millenials 1982-1999 to rise to power, as they have the right mix of "values" (philosophy, circumstantial world experience / view, etc) to move beyond the systems that govern us today — and have for 70 ±10 years already!
I had a hunch post 9/11 that this century would see regimes evolve either towards more political freedom (towards more direct democracy) or towards a more authoritarian form of society (wherein social peace is obtained at the cost of some freedoms). It turns out that I was wrong, it wasn't either/or but both combined in a weird way: political freedom was gained but used to promote clowns to power (#all.over.the.world.the.2010s.are.insane.historically) instead of e.g. tackling massive, pressing or idealistic projects (people be lazy, rite). Whereas actual sovereignty (the one you learn in constitutional law, the real kind of political power) definitely shifted towards authoritarianism under various disguises — populism is one form, China's and Russia's "restoration" of authoritarian federal powers is another, and some self-proclaimed SWJs may not be far either, in their own "inclusive" way (kinda like dictatures are all "Democratic Republic").
What this tells me (I've long studied that evolution but again it's really just my personal view) is that societies are simply not mature for the new "space of possibilities" (think positive variables, opportunities e.g. via tech, think also negative variables, constrains of climate and viruses for instance). It's just too much power, too early, so we basically just F it up like kids with a problem a tad too big for them.
But that's history. We do things and then we figure out how to deal with them, there's no reversing that causality. Hopefully we won't ravage ourselves and this Earth in the 20-60 years it'll take to adapt to this rather sudden paradigm change — think 1980-today, that's just 40 years ffs, and think of the mindset then and now... And you kinda need "natives" of an era to meaningfully internalize its reality, process the whole damn thing in "system 1" like human beings do, and eventually sometime between 20 and 80 figure out ways to make life better. Rinse and repeat with their newborn grand-children to solve the new thing that's arrived by then.
As for what that will actually look like, your guess is as good as mine. I'm partial to freedom personally, but I think it's worth choosing your battles, too. That's when it becomes political thus where we stop: a good regime doesn't favor "opinions" but rather the expression thereof, in a healthy and productive manner (able to reach decision; ideally promoting some degree of consensus, kept in check by some other legitimated power, etc).
Just know that, when we want to, it's relatively doable to write a rather good constitution (and we have, many times throughout the last century). The real tricky issue is not to technically implement the ideas, the hard part is what ideas, what system you actually want to create. Again, many possibilities, some of which were abandoned by history but are now possible because modern tech (notably complex voting systems that yield much better representation of opinions and hierarchies in complex, multi-dimensional systems, e.g. to distribute might and resources between cities, or agencies, or any such module. There's about 1 century of great science that we're barely using for the benefit of the public, troves of innovation in the political realm. Just so much apathy for change in those who man these offices).
(It's honestly a fascinating topic of inquiry if you like systems, puzzles, cybernetics (different name for systems theory), all things mechanical in nature that must work with a "real-world" chaotic human environment.)
- all private employees off-job as much as possible.
- stay in your home.
- don't travel to [many] countries, more restricts will come.
- All indoor cultural institutions, libraries, leisure facilities, etc. are closed.
And today they made a temporary law which will sunset 1 year from now (the law is only in effect for 1 year):
- ability to force people to be tested and put into isolation
- enter homes without warrant when occupant is suspected to be infected.
- much expanded ability to forbid events and collection of people (Note: the permission to assemble is just as fundamental culturally to Danish people as freedom-of-speech is to USA).
- ability to forbid/restrict use of transportation (likely number of passengers in buses, trains)
- suspension of "free choice" of hospitals and quarantee of treatment within some time frame (we have "socialized medicin" where we have a right to treatment within a given time frame)
- allow temporary suspension of other laws if deemed necessary
Why did this happend now: They were told yesterday that Northern Italy no longer has enough resources in their health care system and that there are now official guidelines for whom to treat and whom to let die: https://www.theatlantic.com/ideas/archive/2020/03/who-gets-h...
This is actual case data, plotted with the time offsets shown in the key.
No other country had a ramp-up like that. Right now, Denmark is 5-6 days behind Italy in terms of cases per million inhabitants, and the incubation period is about that time. Really pleased to see some quick decision making on the part of the Danish government.
Freedom of assembly is at an equal level of importance, legally, in the USA, to freedom of speech; they’re set forth in the same amendment.
Culturally, freedom of assembly is, if anything, MORE significant for Americans than freedom of speech, it’s just not relevant to Internet forums, so you don’t hear it much discussed online.
If I understand him right he's pointing out freedom of assembly is just as significant a right for Americans as Danish citizens.
I would go a step further and argue it is much more significant to American culture than Danish, and I feel my opinion carries at least some weight given I am a Danish person living in California.
I was trying to avoid making a comparative statement about the importance of freedom of assembly between cultures; I have no idea if freedom of assembly is important to Danish people!
But I suspect I obscured my meaning by trying to avoid making a statement about people I don't know.
We have just had an announcement in the Netherlands with pretty much the same, except for one notable differnce.
The Dutch government keeps schools open. They say closing schools would also force many parents to stay at home and that many of them are much needed in health care, police etc..
In Switzerland they decided to let schools stay open for the moment, because otherwise grandparents may have been looking after the children, which could have boosted an otherwise intermittent infection vector. Quite sensible I would say.
The graph this blog draws doesn't work that way. The whole point of not overloading the medical system - and definitely not getting it at 100% capacity, is that once you're at capacity, it's not just COVID-19 treatment which stops (which means, all those people who would otherwise survive die) - it's all treatment.
Get appendicitis? Routine surgery, can be done in a few hours. And will definitely kill you without treatment. Break a bone? Car crash? Treating you in emergency now might involve kicking someone else off respiratory support.
The cost of overburdening the healthcare system is not some calculation of a nuisance amount of citizen death over a time period - it's a whole bunch of people who otherwise live full and productive lives, instead stop existing.
What happens when you go above that dotted line is not the continuation of a predictable trend, it is a chaotic bifurcation in behavior which does not have predictable secondary effects. The COVID-19 case load follows that shape. The deaths and long-term health problems do not.
> Treating you in emergency now might involve kicking someone else off respiratory support.
This has been my standard reply to the "It's just a flu" concept for some time now.
Aside from all this, it's incredible how difficult it is for people to think about this using all the info available (long onset of symptoms, asymptomatic spread, high % of hospitalizations / intensive care, etc) plus thinking in the long term.
I know the generalized idea is no face masks if you don't have symptoms, but if we all used them it might have a good effect on curving the spread.
Unfortunately, western cultures associate face mask with sickness, and are frowned upon.
> I know the generalized idea is no face masks if you don't have symptoms, but if we all used them it might have a good effect on curving the spread.
There was never enough for everybody. So second best option is, known infected + healthcare. Health professionals work under heavy viral load, which is positively correlated with your chance of getting sick and having a bad outcome. Which means in an overloaded healthcare system without adequate amounts of PPE (like Italy now), doctors will be dying, even if they were young and otherwise healthy. And dying doctors drops the system capacity too.
(Capacity of most healthcare systems seems to be limited by the amount of beds and ventilators available, but these you can always make - and China is indeed making them full-steam, to help the rest of the world. You can't make new doctors that quickly, and there isn't much of them either.)
Wash your hands frequently, sneeze in your armpit, use disposable tissues, don't touch your face, don't shake hands, don't go to large meetings. This is the standing advice in the Netherlands.
Those are basic precautions that depend only on the availability of soap. Face masks need to be worn properly to work, and in cultures where people don't wear them normally this is an issue. Only medical staff really has a valid use for face masks now, also because of limited availability.
Sorry! It's the opposite for me. What is incredible is having access to Google and 4 days worth of reading material, people(non-experts) want to weigh in on everything from geopolitics, to how to run healthcare institutions, or what the federal bank should do.
If you are an expert in anything watching this play out everyday has become a gigantic nuisance and a distraction. Not because it matters what the herd is debating but because of the effect it has on leaders, decision makers etc. It piles pressure on them to waste time/resources/energy reacting to the herd.
Even with the info explosion the educated herd is as dumb as it has ever been, probably dumber, for the simple fact there is always more info than whatever you hear on the news or can read up in 2 weeks.
As if the educated herd made a diff to the election of Trump or Brexit. Some people argue the response is evolving with each crisis. I haven't seen any evidence of that.
One chilling comment, among many, from the doctors in Italy, posted here a couple of days ago were that stroke victims were not being treated in any way. Basically they were on their own. A condition that was at least manageable, with intensive therapy, was now left untreated and the suffers had severe disability as the only outcome, if they survived.
Sounds like you don't disagree with his underlying argument, just that the cost is a function of both time and height of the curve.
I took his point to be simply that flattening the curve does itself have significant associated costs. That a maximally flattened curve is not necessarily the best approach.
For people who rely on public transport to get to work and who can't work remotely, I think they would argue that the cost / day of flattening efforts itself also begins to rise significantly. That is, the first week or two are less impactful than subsequent consecutive weeks. And that cost is borne widely. That increasing cost may or may not balance out the failure to have the cost axis take into account the height of the curve.
There’s a whole range of costs associated with various preventative measures which could be taken in the face of any risky activity. Some of these things (like encouraging good hygiene) are obviously worth doing, others like canceling all public schools much less so.
And it’s not just an abstract “economic” cost on the X-axis, ultimately it also comes back down to quality of life and even a cost in lives. Actual people losing their businesses, losing their houses, etc.
I can’t help but think of Asimov and Three Laws. Taken to its extreme, robots interpret the law of “not allowing humans to come to harm” in a way that they ultimately enslave humanity.
First, I think the nCFR is fundamentally and significantly overstating the risk to the general population because orders or magnitude more people already have it than have been tested positive. Second, I think the treatment for COVID is pretty basic. With a concerted effort to deploy temporary facilities across the US we could add sufficient ventilator beds for a quick peak in cases and save trillions of dollars in economic damages.
Flattening the curve depends entirely on the kind of measures taken, and the curve also depends on how is the epidemic spreading. Measures taken depend on their effectiveness, feasibility and side effects given a certain situation. It's very hard to argue the economic effects based just on the curve of cases.
However, this guy (who, by the way, is just a developer who has given "a few days of thought" to this issue) does not seem to know anything about this issue but still proposes a conspiranoic theory that HN entertains way too much.
Or perhaps our government is acting and handling the threat, just not in a way mass hysteria on Twitter demands. Knee jerk reaction usually ends up in theater, not proper containment.
(Then again, my government isn't the Belgian government.)
Exactly! From what i have seen, the governments are acting, even in my country with only 3 confirmed cases, the schools are already shut down. It is media that amplify the panic so that no matter what governments do it seems not enough.
The US is doing particularly badly (and going for nonsensical solutions; note the most recent one). Various Asian and European states are being much more aggressive. Some US states are also doing the best they can.
There are countries besides Belgium and the US (thank God!). Sou5 Korea seems to be doing ok, Italy is certainly doing the right things, even China did pretty well, especially considering they didn’t get advanced warning.
In the US, a lot of the action is at the state level, and WA, for example, seems to be doing fine.
The federal response, and especially the testing situation, is complete amateur-hour bordering on negligence-in-the-criminal-sense, yes.
I think Hanlon's razor applies here: "Never attribute to malice that which is adequately explained by stupidity".
I'm in Spain, one of the countries that is doing way too little, way too late. When I see the measures and statements from our politicians, I don't see a machiavellian plan, I see stupidity. In fact, a prominent member of the government has been infected after attending feminist demonstrations on March 8 that anyone reasonably informed and intelligent knew shouldn't have been held in the first place, others also attended and could follow. If they were such diabolical masterminds, I doubt they would have done that...
Except there's not necessarily any malice exposed by this explanation.
To incur massive economic cost is literally deadly. For example, in the UK austerity is blamed for tens of thousands of deaths (some people say 130,000, others 30,000). The unpalatable fact is that trade-offs need to be made when deciding how to tackle this.
In the case of covid-19 I don't envy anyone who has to make these decisions, due to the exponential nature of infection spread making small changes in measures potentially have big results. We are all in uncharted territory. Hopefully the examples of countries such as Italy will help decision makers get it right, or perhaps more importantly will influence peoples' behaviour to reduce transmission.
Also, I think he's wrong about the Y axis equalling "deaths" - the point is to keep cases manageable by the health system, which minimises deaths. Dragging things out doesn't necessarily improve outcomes for at-risk people.
Far more enlightening than reading some inexpert web log with wobbly hand-drawn graphs with unmarked axes is to read the actual after-the-fact analyses of the measures taken against the 1918 Influenza pandemic. People learned from history, what actually did not work. It influenced what they did the next time around, in the 1920s.
Don't read some Belgian web developer's web log.
Read the likes of Ethical and Legal Considerations in Mitigating Pandemic Disease: Workshop Summary published by the National Academies Press in 2007 (ISBN 9780309107693 https://www.ncbi.nlm.nih.gov/books/NBK54167/).
First: SARS-CoV-2 is the virus, Severe Acute Respiratory Syndrome-CoronaVirus-2. COVID-19 is COronaVIrus Disease-2019 which is the disease caused by CoV-2.
Second: Flattening the curve isn't about shortening any duration.
The Y axis is the number of infected.
In the Red Line scenario, like packets overflowing a buffer, patients above the dashed line will (have to) be medically neglected. Rest assured, our immune system will eventually gain the upper hand, the virus will eventually decides its job done, red line settles, we'll congratulate the lucky few who won scarce beds at surviving hospitals, as well as those who treated themselves next to remains of deceased hospital staffs. Then we will assemble at rubble of our cities and start walking towards the former glory of human civilization up until 2020(hyper exaggeration).
The Blue Line, "Flattening the curve", lets us avoid that apocalyptic situation: by boldly suppressing infection early on and spreading it out to a longer duration, ignoring economical disaster ensuing, no patient will be left behind. The hope is that by allowing every patients to be semi-adequately treated WHEN infected(not IF infected), total population of alive and recovered combined at the end of this pandemic at maybe late 2022 or so is going to be far better than the Red Line scenario. So we'd want to flatten the curve.
Green, is just a pipe dream. Makes no sense. If that's possible we might as well get production back up full over in China.
I think there's an important, sub-vocally communicated notion: the containment had failed long ago, and there is an ongoing pandemic. Many stays asymptomatic, some experience manageable illness, some would need to stay at ICUs, around 0.5-1% life will be lost, but we will all(~70%) get infected. Ideas that requires or aims at containing infection or isolating infected few are useless. We must all accept that almost all of us are situationally required to "schedule" an infection, and fortunately, exact time, place or severity of it is left to our discretion.
We must be aware of these facts, and must use it to our maximum advantage, starting from washing hands often.
Since it seems deadlier than the common flu at the moment, I personally would prefer to “schedule” my infection by waiting for a vaccine.
I’m in Latin America where it isn’t spreading as fast (my best guess is warm weather), and I’m planning to wait it out until it’s warmer in the northern hemisphere or a vaccine comes out.
When is too late to act? Clearly Italy acted too late. I've been plotting the actual case data, in an attempt to get some idea of where countries lie with respect to Italy:
These are not strictly predictions, but they give some idea of what will happen if we act in a similar way to Italy. Note that there's a 6 to 10 day lag in the stats (~6 days incubation, up to 4 days testing, at least in the UK right now). Without isolation measures, we're seeing 33% per day increase rates. If we wait until we can measure the scale of the problem, it's likely to be too late to prevent it.
I think there’s a simpler explanation which is that governments are comprised of people, and people are — to borrow a phrase — predictably irrational. We consistently prioritize the short term over the long term.
Take Climate Change. There’s no shortage of brilliant scientists who have warned us of the long term costs (in human toll and wealth) of inaction. Yet we wait.
Unfortunately, scientists are not the ones flying the plane, so to speak. There are brilliant epidemiologists here in the United States. What are their recommendations behind closed doors? Classified. We don’t know. We do know the opinions of the ones who are free to speak their minds, and they have been warning us to be proactive. For years, before this crisis, actually.
The rest of us are sitting in the back of the plane, uncomfortably contemplating whether the pilots have perhaps made a fatal error in their judgement. It happens. Now we wait.
To quote Carl Sagan:
“Science is more than a body of knowledge; it is a way of thinking. I have a foreboding of an America in my children's or grandchildren's time—when the United States is a service and information economy; when nearly all the key manufacturing industries have slipped away to other countries; when awesome technological powers are in the hands of a very few, and no one representing the public interest can even grasp the issues; when the people have lost the ability to set their own agendas or knowledgeably question those in authority; when, clutching our crystals and nervously consulting our horoscopes, our critical faculties in decline, unable to distinguish between what feels good and what's true, we slide, almost without noticing, back into superstition and darkness“
This is all dumb. saying this is unstoppable is a misconception. China reduced cases. South Korea and Singapore and Hong Kong and Taiwan have it under control. This is a statistics game, if you manage to reduce infection rate below 1 you win. the faster you respond, less time it takes. it's also clear, that if you could respond patient 0, that would be ideal, and you can prove by induction from here it's always better to act sooner. There is no reason whatsoever that makes it better to stop the spread after it reached 1000 people versus when it reached 10. What works when you have 1000 cases works
just as well for 10.
Belgium is famous for not having a government many times, and if it has one, it's often not able to act.
Belgium has a pretty divided population (Wallonia/Flanders) and no winner-takes-all election system, and so there's often a stalemate where no majorities can be reached for any votes, including for electing the government officials).
After the last elections on 26 May 2019, the winnings parties have been unable to form a coalition, so there is no real cabinet at the moment which has the power to do the things that need to be done.
We do have a government though (quite a few of them even, but the federal government is the one that matters here) with all the power needed to do whatever it deems necessary.
And the federal government has said that indoor meetings with more than 1000 persons are "not recommended". The Brussels government has cancelled those, the Walloon cities don't have events of more than 1000 persons planned in the near future, and the Antwerp government seems to be using the whole thing as an opportunity to criticize and reject any responsibility on the federal government without taking any decision (as far as I know, the Simple Minds concert hasn't been cancelled yet, and is supposed to have a lot more than 1000 people).
There are actually a lot of governments which each have the power to do things. I personally think that the only reason they don't do anything useful is pure incompetence, irresponsibility and political calculations.
> We do have a government though (quite a few of them even, but the federal government is the one that matters here) with all the power needed to do whatever it deems necessary.
Really? Because I seem to have read that budget deficit is getting out of hand because there is no federal government to fix it.
Also, yeah, fair enough. There are a handful of other governments that technically could take a decision, but as you said: it's easy to say: "well, this is a federal decision, so we won't do anything".
Budget is one of those things that cannot be voted by the current affairs government so they just keep renewing the last budget allowances from the last actual government, as far as I understand (I don't know if it's a legal requirement, or just a custom). Don't take my word for it though, I'm definitely not an expert on Belgian politics.
But the coronavirus crisis is definitely a current affair, and the current government has free reign to do anything it deems necessary about it.
> Why aren’t we going for green though, that seems even better?
Because we want to avoid Covid-19 becoming a recurrent winter illness like other coughs and colds and flu. Those already cause considerable pressure on healthcare systems, and adding annual covid-19 season on top would be pretty rough.
Yes! We don't want to flatted the curve so much that it extends into winter, because then we compound other seasonal illnesses like the flu, and the pressure on the health service is back above the red line.
Let's start with one fundamental assertion that I feel is missing in many of the discussions in this thread: There is no "the government". In most countries "government" is a collection of agencies, staffed by individuals, not completely in sync on all levels (micro, meso, macro).
You see that playing out when measures on one level (most prominently medical advise) are not in line with broader approaches to managing events, groups, tourism and travel. We all notice the disconnect, and some might think of 'dark conspiracies'. There are none (rule of the most kind interpretation). It's the dispersion of institutions in action.
Another one is my assertion, as a former public servant with friends in places that /should know/, that there is no structured economic analysis of possible outcomes of various scenarios of intervention. There are no models, there is no time, there is not enough collaboration between agencies. On the one hand you have the medical staff and agencies doing what they can where they can on a medical level, on the other hand you have bureaucrats making decisions with limited information and way more limited understanding. Politicians probably get in the way more than they support.
My thought: Governments are acting. They are just not acting in a way that we, the public, can understand is internally consistent. That's because the acts aren't internally consistent. That is due to the fact that governement is made up of institutions with different levels of understanding, information, scope and time to act.
In a pandemic, this is all very unfortunate and a more singlehanded style of governement could help. China got it quite right after an initial denial. Nobody in the West is equipped to both think about and act on China-style measures. In normal situation our distributed model of application of knowledge (Hayek) is more efficient. Most we can hope for is rapid learning in our institutions and the fact that a whole lot of capital, both human and monetary, is available for solving this crisis.
I'm quite in a shock (my province is in partial quarantine) with what's happening, but if the world economy proofs resiliant to this shock on a say 2-yr horizon, I'm quite bullish on how strong and adaptable our institutions are and see more hope for f.e. tackling climate change than before.
It’s almost tautologically true that the cost of closures are considered in the decision-making process. This “article” tries to portrait this entirely obvious fact as some sort of sinister conspiracy, with cargo-cult charts to appeal all scientify.
Ethics aside, more fatalities will cause the bigger economical impact as well due to the lower amount of consumers, the lower consumption rate of the survivors (they will lose their close people, relatives, friends), will increase the long-term burden to the public health due to increased depression levels, lower immunity levels, and so on. Moreover, the political damage of the governance system, including healthcare. It's sick that people look just to the first-order effects but completely forget about second-order ones.
Just a little thought experiment:
If the current wisdom is actually that almost everyone will be infected eventually, wouldn't it (ignoring any ethical issues) be wiser to deliberately infect medical personnel as soon as possible, so the 5-10% of infected that need IC treatment can actually get it, before the medical system is overrun by the infected general population. In a few weeks, all doctors are immune (or deceased) so that they are much better prepared when the number of cases in the general public explodes
Probably little evidence for Covid-19, but for SARS, studies in animals have found limited immunity after both infections and vaccination attempts. https://www.medscape.com/viewarticle/706717_1
The more I see and hear about coronavirus, its origins and the knock on effects it has on the economy and society I can only hope that this becomes our 'come to Jesus' moment (figuratively speaking).
This pandemic started because too many people are living together in close proximity, eeking out a living by literally catching and eating any living thing they can.
The economic effects are due to an unforgiving system that takes pride in an 'eat what you kill' culture and a 'winner take all' model of enterprise. As a consequence, there are a LOT of businesses running on thin margins and making just enough to cover costs each month.
Even one month of things going to zero will ruin a whole host of restaurants, sole proprietors, real estate speculators, and on down the chain. I hope I'm wrong, but this kind of instant systematic reduction in the economy feels unprecedented within the last 50+ years.
There are so many knock on effects of all this - people will be unemployed with limited opportunities at best. They'll potentially lose their healthcare, and in the worst cases their homes. Schools are closing around the country, and they won't have lunch programs running which means a lot of kids are likely to go without adequate food.
We need to fix (or create) safety nets in our country (and indeed the world), so when things like this happen we can all chip in to cover each other. Basic healthcare, affordable or public housing, eviction protections, food programs. These aren't radical ideas, these are the only way forward.
I see how the struggle for economic reasons, but I have too little faith in them being smart enough for that plan and doubt they have good enough data scraping by the max capacity line so closely with confidence.
Even the graph in the article is weird, why is there a sharp limit at max capacity in the T2 curve? the virus doesn't care about max capacity....
Yeah, no. Nice hyperactive imagination to find any plausible justification for inaction.
The intuitive impulse is there (trade off hospitals getting "creamed" vs. shutting down economy), but the implementation isn't realistic, so with the incubation period and lag in testing, all governments act too late. It's an impossible control problem.
On the other hand, maybe the right time to act is to watch your stock market. It's a forward predictor. When it starts to tank, go all out.
Governments don't seem to be able to act based on non-local information. Once the hospitals fill up _here_ , then action is taken. Hospitals filling up somewhere else causes no action.
There appears to be concerted disinformation operation underway, using the same outlets used for politics. I live in a "red" part of the US and can see comments from people on local TV news posts, and I talk to other local people. It's pretty clear there is lots of false information being propagated: comments like "Media stop overblowing this", "it's just the flu", "we can still shake hands here, it's a long way away" (that was a teacher at last night's parent teacher meetings). If the population don't have a realistic view of the situation then how can government take the necessary steps?
"Wherever I'm going, I'll be there to apply the formula. I'll keep the secret intact.
It's simple arithmetic.
It's a story problem.
If a new car built by my company leaves Chicago traveling west at 50 miles per hour, and the rear differential locks up, and the car crashes and burns with everyone trapped inside, does my company initiate a recall?
You take the population of vehicles in the field (A) and multiple it by the probable rate of failure (B), then multiply the result by the average cost of an out-of-court settlement (C).
A times B times C equals X. This is what it will cost if we don't initiate a recall.
If X is greater than the cost of a recall, we recall the cars and no one gets hurt.
If X is less than the cost of a recall, then we don't recall."
Here is a discussion of some of the numbers and models. It's in German but I guess deepL should give a reasonable translation. One part of an answer that I extract from this article is that it's complicated. People do have more sophisticated models (see some of the ones mentioned in the article), the issue is these require more parameter inputs with significant uncertainties (we really don't have enough information on the virus yet). if some government would come out and say this is the model we are using you would immediately have lots of discussion about the validity and how everything would be easy peasy if we just change this parameter.
Another aspect is probably that accurate modelling is not the primary focus right now.
It's ridiculous to imagine governments are doing the best thing possible and then try to decode their actions from our inferior standpoint, like if they were full of wisdom we just don't understand -- more likely doing the worst thing possible and we are the victims.
He just relabelled the curves for no apparent reason!
To make it clear: The vertical axis should not be number of deaths. While the number infected remains below the health system capacity the number of deaths should remain relatively low. But once it hits capacity there is a step function that ratchets it up.
And the horizontal axis isn't cost at all. The green line shows something that is within the normal capacity of the health system. There aren't additional costs and so should be relatively cheap.
And the green curve is great - everyone would like that - that's the normal Flu. The Blue curve is the maximum we can sustain without overwhelming the health system.
I don't know who the author of this blog is, but this was sincerely the least insightful article that I've ever read. Kindergarten level, crayon drawn graphs were representative of their insight.
What I see is that the impetus to action starts from below and works up.
New York City declared a state of emergency first, then the state. I guess the U.S. is in a state of emergency because it is shutting down flights. For a while people were accusing WHO of inaction, finally WHO declares a pandemic and they start accusing other people of inaction.
The structure is that an outbreak creates a crisis in one spot even though others are currently unaffected.
While it's true our federal government hasn't issued orders but only advice the local and provincial authorities have the power to prevent some things from happening. And they are using it: some classes or schools are getting shut down, some away trips are being cancelled.
But I agree, everything's fine in Belgium :D. The virus is likely to have taken a detour to avoid Belgium, like the Chernobyl cloud did.
I've read a lot of dumb COVID-19 takes, and this has to be in the top 10.
Disregard the wishful thinking, psychopath level lack of empathy and poor graphing. The problem with this is the lack of any actual model or incorporation of any variables that disagree with it. Things like confidence, certainty, the value of all those parents & grandparents.
The action that any government should take now is find a cure for the virus. Collectively pool resources, bring up the brightest minds in health sciences and devise a way to remove the virus from the equation. The fact that despite lockdown and other government actions and the virus is still spreading just mean that all this measures would become nil at some point.
I had the impression they are doing so. All the measures taken now aim at flattening the curve. Which spreads cases out to prevent ICU beds and hospitals from being overwhelmed. This helps to keep the hard cases alive and buys time.
Which might also explain why countries act differently, the max threshold for the respective medical system is different. As are projections of the spread. But I don't think we have to believe governments aren't analyzing the development daily at least.
This the type of analysis that comes from people who spend most of their lives analyzing data. If you were to go into the offices of the elected and the offices of the government, you would generally find the same thing:
The actions they are taking are based on what they feel will serve them best.
This should be the first assumption in the analysis.
It depends, a lot of european countries right now are banning events that have more than 1000 people, schools are closing down and simmilar places. Technically, they need to push the agenda even further as everyone should buy more so that the economy would not collapse as it is already near that
This all assumes that executive level government functions rationally and in the long-term national interest. Which is normally the case, but this is an abnormal decade.
Let me be extremely cynical (at risk of down-voting) about the current US administration's motives:
Consider Trump's just-announced travel ban on the EU-26. It misses out the UK and Ireland, despite COVID-19 having a toe-hold in those countries ... but the UK and Ireland have Trump-branded golf courses! A ban on travel from UK and IE would hurt their viability, so it was quietly omitted.
Meanwhile, the Trump hotel chain is being hit as badly as anyone else in the hospitality trade by fears of a pandemic, and revenue of his hotels in Florida is driven by spring break traffic. So he's downplaying anything that might reduce vacation travel at spring break.
Denying that COVID-19 is anything to worry about is personally advantageous for Donald Trump as a hotel magnate, because it protects his investments. It's disadvantageous for the USA as a whole, but where do his priorities lie?
His travel ban was for schengen EUrope countries, many refer to them as Europe, when they are only part of it. Much the same way that some think the UK is leaving Europe and fail to grasp the difference of economic areas and tectonic plates.
Honestly should of just said, all air travel. How the thing spread to other countries in the first place.
Still, I'd be supprised if London don't end up with quarantine zones before the month is up. Going by how it has patterned in countries that have had to move from containment onto delay. Then it's not a case of if, but when.
I know this sounds like a lame joke, but it is not.
The true reason why Belgium is not doing anything, is because they can't form a government, let alone take these kind of coordinated measures.
At this point, the writing for the USA is on the wall: either institute a national quarantine policy, or face a mass die off of hundreds of thousands of the elderly in the next couple months.
We need to start the national quarantine before things blow up to Italy and Wuhan level proportions. Yes, it will be extremely costly. But riding on imaginary hopes that the virus will just disappear for no real reason is extraordinarily irresponsible.
The details of what it looks like will take time to figure out--it will be a complicated collaboration between the federal, state, and local authorities, with the justice system and health sectors being deeply involved. That's reason to start figuring those details out now, and not two weeks from now.
Donald Trump was elected because he said he was a risk taker willing to do what needs to be done despite criticism from everyone. A national quarantine is needed now, and we need bold action to get it started. This is his moment to make a difference.
Hospitals will only allow visitors if they are over 16 and a primary caregiver (ie spouse), and even they are screened before being allowed in. Nursing homes are limiting visitors, both who can come, and where they can go. Companies are halting non-essential travel.
It isn't as drastic as you might think it should be, but it is significant at limiting risk for the most vulnerable.
Most of the above is running plans that have been in place for a long time (far longer than Trump), walking the line between overreacting and things getting out of control.
How long is the pandemic expected to last? What are the furthest out conferences that have been (or should be) canceled? How is the end of a pandemic even defined?
Or government is acting according to the threat it poses. It has been three months now since it has moved globally. Likely longer actually. This isn't a plague killing everyone in its wake. It is the newest Y2k, 2012, Bird Flu, or Global warming hysteria push by governments and the media. Look at news from China, they are using it to be more in control except now with support. This going to blow over with little interuptions due to the virus itself. I bet more deaths arise from lack of service due to people inundating the ERs with negative cases than the virus causes.
This is just one guy thinking that government know what they are doing and that they are "fine". I have read other delusional thinking on Reddit along the lines of "Trump seems to be so confidant, this must be a bio-attack on China/Iran and somehow the virus is not going to spread in the USA". This was before the virus spreading to Italy and Iran/China being the only countries with breakouts.
This kind of delusional thinking is not very different from religion and believing in God. People who believe in God, when they are found in hard situations, will think that somehow god (the savior) will come for their rescue. Apparently, people who do not believe in God will think that somehow the universe/government or whatever will come to their rescue.
The issue is that people holding power/government seems to be, eh, usual folks. They are still operating with a normal brain which when confronted with abnormal situations that it can't handle will just imagine that stuff is going to return to normal.
Bill Gates has already warned about something close to the Coronavirus and that we are very far from being ready. Nobody was listening and my guess is the change is going to happen through natural selection.
So I encourage people to go watch the Joe Rogan podcast on this [1]. A few snippets:
- He describes this as more like a "winter" than a "blizzard" in that this is going to go on for months;
- No one really knows what the mortality rate is but it's become clear there are certain risk factors eg the fatality rate among people over 70 in China is about 3x for men than women but men are much more likely to smoke than women in China in this age group.
- Keeping schools closed is a mixed bag. For one, kids below 9 or so don't seem to get sick or die. In China only 2% of cases are under age 19. There are other diseases like this (eg Hepatitis-A). If you keep kids home, some people will lose their jobs or simply be unable to work as they take care of those children. Some of those people will be health care professionals. The lack of those will likely kill people;
- It's unclear yet what other risk factors (other than age and smoking) there are. Obesity in the developed world is a big cause for concern as this unfolds. A stat quoted is that 45% of people in the US aged 45 and older are obese or severely obese;
- It's largely a question of when not if you'll get this;
- It's a myth that we'll have a vaccine before ~18 months. You can't rush this. It's like trying to rush a pregnancy.
- Italy is a window to how most places will be in ~3 weeks;
- We, as a society, have a short attention span. We could've developed a vaccine for coronaviruses after previous outbreaks (SARS/MERS) but there seemed to be no appetite for that when they faded;
- Disruptions to the supply chain are likely to be the biggest problem. We don't stockpile anything and we're dependent on China for a lot of medical equipment (eg respirators) and a bunch of essential medicines, some of which people will die if they don't receive.
The guest here (Michael Osterholm) is an expert on infectious diseases and the author of Deadliest Enemies [2].
I can't speak to the reaction of different governments. It's no surprise there's variance. This probably comes down to just 1 or 2 personalities.
I think HN should enact stronger Coronavirus-related moderation like Reddit has. This is a bad post from a software engineer (not a health professional) and it offers an amateur analysis without even providing a real suggestion. What benefit does this provide in a crisis?
posts from health professionals can be even worse. this one was not too bad at explaining the thinking of ruling elites (who think they can fine-tune an epidemic)
Not too bad? This is a post from a guy who, from his Twitter, "has been thinking for the last few days" and somehow he knows the thinking of ruling elites?
Honestly, I am really surprised that this post is being upvoted at all. Empty speculation for no reason at all.
It's also very wrong, as it depends on what measures are required for each curve, and as it seems clear, this guy does not seem to know the possible measures at hand, their feasibility and effectiveness.
"this one was not too bad at explaining the thinking of ruling elites"
By inventing a completely unsupported rationalization/conspiracy theory?
"Ruling elites" are not omnipotent, and paradoxically most are in the most vulnerable demographic. And as others said, it is a situation where one can be damned regardless of which way they act.
In the case of strong containment/quarantines, unless you're willing to completely close the borders indefinitely at this point it is futile doing maximum containment: it's past the point where you can stop it, as the world managed to do with SARS and MERS.
At this point every government is vulnerable to every other government, and further vulnerable to the possibility that there are super-carriers spreading it. And FWIW, a number of countries have a done a very good job of managing it, but again it isn't a closed-loop.
French President Macron seems to be doing what this post is writing: trying to fine-tune the spread, and find a balance between economy and health, with proportional measures
They don’t act because they don’t care. It’s people dying, and their eyes are focused on purely economic metrics, not the well-being of the population or its survival. In the particular case of Europe, this is not the first thread that is totally discarded by the ruling elite, it’s the usual way of acting. It’s more visible with the virus because the timescale is shorter, but fundamentally there is no difference with how some other important threats are handled (for instance, see how the current acts of war from Turkey against Greece are handled by France and Germany).
TLDR: It's cheapest to let old people die, so that the young can continue working.
A very cruel view on humanity, but I would be surprised if these thoughts hadn't crossed our politicians minds.
Also, many initiatives by young people (e.g. limiting climate change, re-structuring society to be more equal-opportunity) are being blocked by old people who wish to preserve the status quo. So there is a general dislike by young people - those mostly unaffected by Covid - against the elderly - those most likely to die from Covid.
And for many years, there have been heated discussions about whether it is fair to force an ever smaller number of young people to pay for an ever growing number of old people, even if those old people directly undermine the young people's livelihood, for example by driving up rental prices or by voting to stop free education (which they themselves benefited from, when young).
So you could probably even win some young votes with a platform of "let's sacrifice the unneeded grumpy grandmas for the greater good".
Of course, everyone will hope that it's not their own parents, but only that one grumpy old person in the neighborhood that everyone dislikes anyway.
As for the reasons of why there is a divide between young and old, I guess a big part is jealousy, because the older generations had more stable job opportunities available to them.
Standard Foreign Office response in a time of crisis:
In stage one we say nothing is going to happen.
Stage two, we say something may be about to happen, but we should do nothing about it.
In stage three, we say that maybe we should do something about it, but there's nothing we can do.
Stage four, we say maybe there was something we could have done, but it's too late now.
https://youtu.be/nSXIetP5iak