To be clear, the Korean government officially still recommends social distancing. They are especially worried about the family picnics mentioned in the article, and have officially closed many public parks in response.
To repeat: don't take this as a sign that Korea believes it has successfully managed the outbreak.
I'm actually slightly worried as Singapore seemed to have handled the crisis quite well with only 1000ish cases for the longest time, but have now had cases balloon from only around 1350 total cases two weeks ago to 6000 today.
Certainly, a lot of it has to with migrant workers and their living situations, but it also underscores how even when you have things under control, the virus can spread rapidly when your guard is down.
Tbh, SG should have never let people come particularly from countries with covid outbreaks during March. While spreading across the dorms is a big part of the internal spreading, it's clear the outbreak that started in March were clusters involving people coming to sg from abroad.
Almost everyone shut down travel from China (particularly Wuhan) but no one shut down travel from Europe during March. Biggest mistake ever. I don't know enough if it was tourists or whether it was returning Singaporeans but they should have instructed them to remain where they were for the sake of the country.
Kind of - it closed the borders for Europeans traveling to the US, but did little to manage Americans returning from abroad. Given March is winter in the US (thus less tourism), I would imagine the majority of Europe -> US traffic at the time is Americans returning home, that's a rather weak closure.
I think you are diminishing the amount of traffic between Europe and US on any given day. Closing the borders to Europe may very well have saved us from catastrophe. Numbers exploded everywhere in March.
My point was that tourism to the US is probably not uniform throughout the year, and March is likely on the lower end of tourism. Hence the ratio of traffic being Americans returning home is higher.
The vast majority of people entering Singapore in March were Singapore citizens returning. A lot of them were students who came back because the schools had closed.
The mistake was not letting them it, but to let them self-quarantine at home. This led to them infecting other family members who then spread it further.
This has changed now as anyone entering Singapore has to be quarantined in a separate facility.
Why is letting them stay where they were an issue? The country (an isolated island, Palau) where my parents are from did that even for students and it's kept covid19 from reaching there till now. Given their situation, they can't afford any cases at all until there's a vaccine. I get you care about your citizens abroad but it's clear that's where all the hotspots in sg turned up in March.
It will be fine as long as the medical system is prepped to handle surge/moving overflow smoothly/pulling in and sharing resources etc.
Remember most positives won't require hospitalization (~50% wont even show any symptoms, 40% will have mild symptoms). And compared to few months back readiness/awareness levels at hospitals is much higher.
It is closer to 20% A lot of articles stating more are mis-interpreting those numbers from prospective studies. It is possible that the authors of such studies would downplay false positives as well.
50% keeps recurring because multiple mass testing efforts found that half of tested people were asymptomatic. However, that is mostly a function of a long incubation period. A significant portion of the infected developed symptoms later.
I think they don't know yet, even the US were saying it might be 25-50% a couple of days ago. For example the testing of the aircraft carrier, one of the few cases of total population testing, showed 60% asymptomatic cases but had a young population, and it's not clear from the information we've heard publically if some of those will develop symptoms later.
The calm before the storm happens in countries that are not testing people adequately. The numbers seem to explode when they really start testing.
South Korea is still testing aggressively. Recently they even started re-testing recovered patients. Those who tested positive had their contacts traced and tested too. As long as they remain vigilant, they will not see another big explosion. They seem to have the right attitude.
I’m waiting to see if there will be a little outbreak as a result of the elections they held recently.
Couldn't find a better page, but according to a past version of wikipedia table[1], as of Mar 31, Japan had tested 32,497 people. The US had tested 1,108,500; South Korea, 410,564.
A lot of people were perplexed by Japan's lack of testing. Seems like Japan's strategy (whatever it was) didn't work out in the end.
Nobody believed Japan. Trump had to call Abe to consider postponement and Canada was the first country to announce they wouldn't send their athletics to the summer Olympics in Tokyo on March 22.
Almost all new cases are from clusters in dormitories for migrant workers. They live very close together in those locations, and things will spread very fast.
Numbers outside these locations are going down because of the recent "circuit breaker" they introduced a few weeks ago.
To repeat: don't take this as a sign that Korea believes it has successfully managed the outbreak.
South Korea has had fewer deaths than other nations, South Korea has a semi-open economy now. What better model for managing the outbreak is there? (The condition of Europe and the US look very dismal) It's kind of strange seeing this claim with no substantiation beside "repeat" apparently staying on the top of HN for a while.
South Korea hasn't entirely averted the danger and is clearly still keeping it in mind. The virus is going to be around for a while and normalizing life is needed and it seems South Korea has to the testing and contact tracing infrastructure needed for this. What is the counter-argument?
South Korea suppressed an epidemic and strengthened the tools they had for suppressing epidemics, maintaining economic strength and social cohesion.
How are they not best position in the stage of managing the epidemic (the appropriate term used by the ggp).
Oh, I know one really bad answer people are ready with - they didn't let the virus burn through their population to acquire herd immunity. The degree to which any other approach is going to leave a society ready to deal with new waves of this seems really, really low. Certainly, current US events aren't preparing for any future crisis.
Well, for one thing, people were saying the same about Singapore, but the number of cases there has grown exponentially. A pandemic isn't over in a few months, we have to look at it over years.
For example: behavioural scientists tell us that people will only stand one major lockdown; using that lockdown early to keep deaths to a minimum initially may not be the best strategy. So thinking about the long-term is essential.
Not saying you're wrong that South Korea has a good track record to this point. I am saying you're wrong to extrapolate that out to the likely arrival of a vaccine programme in 2021.
In that case I wouldn't trust any country not to fudge the numbers. As far as Japan goes, I believe the numbers are close enough. They have a very high population of elderly and smokers. People would be dropping like flies and making a lot of noise about it if the numbers were far worse.
Social distancing, wearing masks, staying home when sick, cleaning all fomites frequently are things the Japanese were doing before this pandemic culturally, I imagine those actions are in over drive now.
I'm reminded of when the subway tunnels in Japan flooded and the water was so clear you'd have thought it was a swimming pool. Even Chinese netziens commented on how absurdly clean Japan is when the pictures emerged.
Japan had been under-testing and under-reporting to save their face -- or the Olympics. As recent as last week, their health official confessed they had a testing capacity for only 200 per day in Tokyo. Japan's case number and death started skyrocketing since the Olympics postponement on March 24 and nobody thinks it's just a coincidence.
Also note Japan has a large elderly population, or about 32+K, who die unnoticed in solitude every year.
Japan was certainly trying to save the Olympics but when it became clear nobody would attend, numbers "skyrocketed" the same way US numbers did, ie. we started actually testing people and confirming what everyone else already knew, that this thing spread like wildfire.
Testing isn't even useful at this point, we should operate under the assumption everyone has or will have it, and just treat those who are having complications. You don't need to get tested to know you have a cold, just deal with it.
Sure, which is to say, Japan intentionally deceived the world -- they under-tested and under-reported their case numbers to project a false perception of safety and control before the Olympics.
We didn't even have FDA approved test kits until last month, I imagine that similar agencies exist in Japan which required government intervention to expedite the process. I know you want to believe they had nefarious intentions but bureaucracy and incompetence are often the culprit when it comes to government.
In the US it wasn't just a matter of getting tests made, but getting all the various states and private testing centers connected so the federal government could aggregate the data. Smaller countries or those with socialized/public healthcare had an easier time at this because their systems were already unified. Tiny countries like South Korea trying to talk down the US for not getting tests out as fast is them is humorous. California alone has greater landmass and 80% of SK's population.
Besides that, Japan is still doing very well despite their population density meeting/exceeding many major hotspots. And the US is likely out of the woods, we should definitely be back to normal next month.
The article and discussions about Korea seem to mainly revolve around testing and contact tracing. These are complex and expensive, and substantially more difficult to manage in a country like the US which is 7x the population, and is somewhat decentralized (50 states).
Meanwhile, the on the street observations in the article are: masks, masks, masks. Masks are cheap and easy. So let's start with masks, masks, masks first while we figure out and ramp up testing and contact tracing.
the first Apple store to reopen outside China had lines snaking out the door as many South Koreans -- almost all wearing masks
At Han River park in Seoul’s Banpo district, families -- also in masks -- were having picnics
including requiring voters to wear masks and disposable plastic gloves while casting their ballots
People are still wearing masks and mind talking face-to-face with strangers
I think in principle hindering spread is much EASIER in the US than in South Korea.
The US has a huge advantage in its low population density and spread out population. That slows down the spread of disease. Not to mention the advantage of a car centric society. In the US you can travel from A to B without exposing yourself to other people. Americans also mostly live in separate houses further reducing the risk of the spread of disease.
All through human history population density has been a major contributor to pandemics. One can see e.g. how New York is much harder hit than LA. LA is low density housing and almost no public transport.
Europe and Asia in contrast is almost all more like New York. IMHO that makes the success in South Korea more impressive not LESS.
We see the same in Europe. The densely populated countries tend to be harder hit. E.g. Denmark has enacted equally strict measures as Norway sooner yet has twice the number of deaths. Norway has an advantage in being more like the US, having a relatively spread out population.
I don't think the decentralization is the main problem at the moment. Germany is also decentralized. It is a federal republic like the US. However unlike the US, Germany has a cooperation oriented leadership where the central government listens to the leaders of the states and coordinate with them.
In the US it seems to be all postering and blame game. It is very hard to evaluate the US results without taking into account its current disastrous leadership. The US is lead by a reality star. Germany is led by a former scientific researcher with a PhD in quantum chemistry. Should we be surprised why Germany is having the best results in the West, while the US is rapidly approaching the worst results?
What saves the US is that there are numerous governors who are good leaders and to some degree counterweight the absurdity of the federal government.
But seriously in what country does the President encourage riot in provinces of their own country? Looking from abroad the US is looking increasingly like a Banana republic. I how things work out fine for everybody. But I am worried.
I hope you are not including Cuomo — the governer at the epicenter of the worst hit NY — in your “list of good governers”? This was his quote from early March:
"People are reacting like this is the Ebola virus. This is not the Ebola virus. This hysteria that you see, this fear that you see, the panic that you see is unwarranted. We have dealt with worse viruses. This spreads like the flu, but most people will have it and they get on with their lives."
As again with political analysis, I am seeing downright inconsistencies and biases in judging responses to this pandemic, based on what side one is on. Do you apply the same remarks to the POTUS as well?
> Not to make this too political but can't the same logic be applied to the POTUS too? Changed tone and done a decent job using the fed muscle to beef up on ventilators and testing. What am I missing when I hear contradicting analysis around politicians, presumably based on which "side" one is on. We should be consistent in acknowledging that no one (at least in the US) got the severity of this correct.
The same logic does apply to President Trump. But he has not changed his tune. He's done some of the right things under pressure, but then goes and says that he wants to re-open the country by Easter, etc. I don't follow what he says closely (after all, I don't live in the US), but the picture I've gotten about him is that he's inconsistent and not really trustworthy.
> then goes and says that he wants to re-open the country by Easter
From what I noticed (it's been a while) the reporting on that was a bit weird. The statement was more like "I hope it'll be fine by Easter". That's still a weird thing to say, but less strange than what was reported.
The way statements were made to the public seems to be different per country. E.g. in NL the prime minister said something like "we need to take this very seriously and it will take a long time". They showed a similar presentation from France, were the statement included stuff about "fighting a war". So despite needing to say similar things, the messaging can differ quite a bit per country. In US the statements seem quite strange; dismissing the importance as authority figure seems dangerous and irresponsible.
He’s pretty much right though. It spreads worse than the flu and Dr. Ioaniddis recently published a serological study showing it seems to have a mortality rate similar to the flu. An overwhelming majority of people who get it will not die. Ioaniddis et. al. suggests the evidence points towards 1~2 out of a thousand mortality rate.
We should not be panicking. We should be mitigating the disease based on the evidence at hand.
[citation needed] about cherry picking. The limits of their scheme was acknowledged and discussed in the paper. What cherry picking are you referring to that wasn’t addressed?
"I think the authors of the above-linked paper owe us all an apology. We wasted time and effort discussing this paper whose main selling point was some numbers that were essentially the product of a statistical error."
I'm skeptical whenever I see a teardown like this which fails to mention that the offical case counts have all the same problems. Maybe we should dismiss this paper - but that means committing ourselves to radical skepticism about the prevalence, not going back and believing the numbers printed in the news.
PCR tests are asymmetric. Positive result almost certainly means that this person has the virus, but negative result might mean a number of things. Bad swab (less than 3000 virus copies), temporary remission (Korea has at least 160 such cases by now), etc.
Test kit availability adds another layer. At some point New York had 200 confirmed cases, and two weeks later 400 deaths, yet CFR is unlikely to be as high as 200%.
So yes, all statistics should be taken with a grain of salt, but magnitude and direction of that grain may be different.
While Gelman does point out to issues that may invalidate this paper (test specificity, mostly, and noisy weights, potentially) there does not seem to be any "cherry picking" involved.
I would say even if the study is merely statistical error, using it to give an implausibly low estimate of the IFR that just happens to fit the agenda of one author qualifies as cherry picking. A priori you can not use a test with high false positive rate to do a study like this unless the prevalence is much higher than the false positive rate.
If I were to make an informed estimate based on the limited testing data we have, I would say that covid-19 will result in fewer than 40,000 deaths this season in the USA,
He also predicted about 10,000 deaths in total in his mid-March article -- and he even meant that number without any special measures like social distancing and WFH.
No, Imperial gave an estimation of what would happen without measures, but there were measures taken. So in their case, it's natural that the actual number (with measures) would be much less.
Ioannidis' already 4x surpassed prediction was 10K deaths without measures.
Given that we have 4x WITH measures, this means we would be many times more wrong if we followed his advice and didn't take any...
If he's off by 1.5x (IHME model predicts 60k fatalities attributed to COVID-19), surely that's miles better than the what - 50x predicted at the start (I recall seeing 2mil fatalities passed around by Imperial for the US)? 40k deaths is a little less than a week of natural deaths in the US, for scale.
It's worth putting his actual statement here, so people can decide whether you're misrepresenting him.
From his article [1]:
> If we assume that case fatality rate among individuals infected by SARS-CoV-2 is 0.3% in the general population — a mid-range guess from my Diamond Princess analysis — and that 1% of the U.S. population gets infected (about 3.3 million people), this would translate to about 10,000 deaths.
He ventured a prediction of the CFR. And then just calculates the amount of deaths from a pretty arbitrary infected percentage of the population (there's no mention of the time scale either). Never does he predict that 1% will be infected. He's arbitrarily picking a number to illustrate the amount of deaths we'd see, but that all depends on how the disease spreads. Oddly enough his serology study ends up being somewhat close - instead of 1%, they saw 1.80-3.17% (in Santa Clara).
But he uses exactly this in his argument, in the same paragraph: "If we had not known about a new virus out there, and had not checked individuals with PCR tests, the number of total deaths due to “influenza-like illness” would not seem unusual this year. At most, we might have casually noted that flu this season seems to be a bit worse than average."
Then later: "Some worry that the 68 deaths from Covid-19 in the U.S. as of March 16 will increase exponentially to 680, 6,800, 68,000, 680,000 … along with similar catastrophic patterns around the globe. Is that a realistic scenario, or bad science fiction?"
Then he claims that "The most valuable piece of information for answering those questions would be to know the current prevalence of the infection in a random sample of a population"
But I claim he already had, at the moment he wrote that article, much better data than that already available: specifically, that all the statistics everybody could find even in the Wikipedia already gave much more information that he claimed has to be obtained by "a random sample of a population."
One can evaluate "how random" all already known cases, at the time he wrote the article, were. But also one can evaluate, if these known cases, even if they weren't random, were actually saying more, not less, by the nature the numbers were obtained.
And that was exactly the case: time and again, in country after country, the statistics included much more people than the small randomness based study would include, and it gave reasonable estimates about both the speed of the spread and percentage of the people affected.
His argument was not based on analyzing already available data, but on "not knowing" by *refusing to even look at the already available data.
Which is fraudulent, ignorant or both. But there were some big names doing exactly the same, exactly at the time he published that article. So his article was just political, not scientific at all.
at what multiplier would you consider being skeptical about what he says.
your comparison of the 2 mil which was the worst case scenario months ago, and now irrelevant, with 40k which was his prediction from 10 days ago is wrong.
You have to read the study’s details, not just the number in the headline. The IC report’s highest number was looking at what would happen if strong countermeasures were not taken, and they subsequently were — it’s like criticizing the justifications for mandating seatbelts because so many fewer people die in car crashes now.
that's what I am trying to tell him. comparing his prediction a week ago with measures to a prediction a month or more ago without measure is pointless.
The Ioaniddis survey was a total sham. The true fatality rate will wind up being something like 1-2%, if counted by excess deaths.
A town in Italy, Castiglione d'Adda, had 1.4% of its population die in March. Normally 0.1% dies in a month. That town did a serological survey of blood donors, and 70% came up positive. That exact number won't apply everywhere because there are different age distributions, different comorbibitities, different genes, etc., but that is the ballpark we're looking at.
0.15% of New York City has already died. That should tell you how reliable Ioaniddis' numbers are.
Exactly. I wonder how many lives could have been saved if we (western/European countries) didn’t have such an aversion to wearing face masks, even in a time of pandemic?
I wonder how many lives could have been saved if we (western/European countries) didn’t have such an aversion to wearing face masks
My wife and I were one of the few people wearing masks at the start of the pandemic, before the closing and work from home orders came. We were harassed by random people shouting at us.
Also, I don't really get the societal penalty for disaster preparation. It's completely illogical. Just a few weeks before the news was really onboard with the pandemic, a woman at my apartment was looking at how many amazon boxes I had on my hand cart. I told her, "In times like this, it pays to be prepared." She looked at me like I was scum. My understanding is that some news outlets were actually denigrating disaster preparation at that point.
> Also, I don't really get the societal penalty for disaster preparation.
It makes a lot of sense: if you're preparing for a disaster, you won't go down with everyone else when disaster strikes. This creates some feeling of resentment which caused people to lash out at you.
you won't go down with everyone else when disaster strikes. This creates some feeling of resentment which caused people to lash out at you.
A well known psychologist was castigated a few years back for his likening people to lobsters. Yet here we have a perfect example of people acting like the proverbial lobsters who drag the escaping lobster back into the pot.
I was in a similar position at work. I was continually pointing out from mid-January onwards, that this was a serious issue that might spread world-wide. That we should at least conduct some tests/drills to insure that our business could function remotely. I was treated like a third head had grown atop my shoulders.
Jump to mid-March, when the pandemic was obvious to anyone with the least amount of curiosity, and the same group was saying "It's just a flu." The only thing that was socially acceptable to discuss was how many guns you might need in an apocalypse.
Technically, not an influenza virus. However, from what we know of virus diseases that cross species, it's not the 1st time a virus with this severe capability to spread rapidly has crossed over into humans. It's also not going to be the last.
The aspect of that statement that's true, which is worse than a lie, is that, "It's just a flu," puts people in mind of a disease that's a normalized part of everyday life. It's often the case, that when a virus crosses over to our species, the situation is far more dire than normal.
IIRC, when syphilis crossed over into humans, it would flat-out kill people in 2 weeks.
My best theory so far is that when it comes to telling people what they themselves need to do (as opposed to inactionable general fear), mainstream media narratives are based around telling audiences the easy answer that they want to hear - eg you don't have to do anything to prepare, and those that do are wrong. Obviously this has always been an ongoing quality (eg no need to oppose the Iraq war since it's just), but with a public health emergency it's front and center.
Well, it was impossible to buy masks for much of the lockdown in France, so…
But banning the sale of masks isn't the most stupid idea we had in France, I'd say it was forbidding jogging from 10h to 19h in Paris was the worst, with all the joggers clustering from 8h to 10h and 19h to 20h
No one has done a controlled study on this, so no one really knows. It ranges from zero to many.
The reason government and medical signaling on the subject has been so mixed is that it isn’t apparent they are very effective, especially the jury rigged cloth masks that people are using.
Even basic mask works quite well in stopping infected person spreading it further. This isn't some recent covid-related revelation, but long known fact. To say it for the 1000th time - this doesn't make you magically virus-proof, but significantly lowers the infection rate of those who have it. On large enough scale, this behavior makes significant difference in infection rates.
I have yet to see a single western leader to recommend those masks for all the interactions (indoor at least). Case point - yesterday I went shopping in fairly large supermarket in Switzerland, and there were maybe 5 other customers (out of at least 100 in the store during that time, probably close to 200 plus all the staff) wearing masks, or gloves. People at least often kept their distance (not always possible in aisles), but that's about it. In a country which has one of most per-capita infections globally.
Why? They rely heavily on politicians doing right stuff. Mostly it works, but in these times politicians prefer keeping economy running (they delayed strong measures when things were getting worse than bad in Italy few kms from their border due to fear of financial impacts... well now they are worse but delayed by few days).
New York and New Jersey have gone past recommending masks, and have mandated them for anyone out in public, along with limiting the number of people allowed to go into a store, and a 6ft distance in any line/queue.
There are many controlled studies on other respiratory disease like the flu, and some on other corona viruses like SARS the show high efficacy of masks. If you doubt the science, fall back on common sense. A respiratory barrier is going to have some value in diminishing the ability of a respiratory virus to spread.
The reason government and medical signaling on the subject has been so mixed is that it isn’t apparent they are very effective
The reason signaling has been mixed is because they were trying to preserve supply for medical professionals. The reason that medical professionals need them is because they work.
>No one has done a controlled study on this, so no one really knows. It ranges from zero to many.
Can't remember seeing any controlled studies on the efficacy of social distancing either.
Many of the healthcare professionals in the countries that dealt with SARS are calling for universal mask wearing.
I'd much rather trust their intuition and judgement than governments and media outlets passing the buck to the WHO.
> Can't remember seeing any controlled studies on the efficacy of social distancing either.
No, but we have mountains of evidence from respiratory diseases throughout history, including the common cold and seasonal flu, that distancing lowers transmission.
It's why people are encouraged to stay home from work when they are sick, and why in normal situations, people in lines of work where they cannot afford to stay home from work get sick more often.
Social distancing is one of the oldest public health protocols we have for disease transmission control.
Sure, many old practices for disease prevention amount to nothing but old wives tales, but social distancing likely isn't one of them.
They don't have to always work well. If Alice's mask stops half the particles and Bob's mask stops half the particles, the chance of Alice infecting Bob is now 4x lower. 50% is not as good as 95%, but surely better than 0%.
All we need to do is bring the reproductive number below 1, not necessarily all the way to 0.
I've also seen a tendency for people to disregard all of the other social distancing measures now that masks are more common. Squeezing up next to someone to grab a bunch of parsley rather than waiting 5 seconds for them to move on. Tons of face touching from adjusting masks too.
Well, first of all, there were no masks to wear. Not even enough to properly equip all medical personal. But yes, if people would wear masks whenever there is the risk that they are sick, be it Covid-19, the flu or just a cold, it would be beneficial.
You can make them yourself on a sewing machine, or even sewing by hand if you're desperate. My partner and I have made ~20 in some of our spare time in the last three weeks, for ourselves and our close family and friends. It's not high tech.
Didn't even have to go out and buy more materials.
Making your own masks is certainly something many people can do, but also many that can't. But many who can, are doing that now. And slowly the supply of commercial masks is improving here in Germany too. As the lockdown is slowly released, people will be wearing masks and that should help a lot with keeping infection numbers down. And hopefully wearing masks becomes standard now when affected by any kind of infectious disease.
Although only maybe half of the people around where I live are wearing masks of any variety, it doesn't hurt to wear a bandana or a buff or whatever when you go into a store. It probably doesn't do much good but it doesn't hurt and isn't any real effort.
we don't have an aversion to it. Neoliberal governments went out of their way to chastise mask wearing because it would paint a bad picture as they wanted people to actually just die "for the economy".
Also, they are very meticulous about taking their shoes off before going into a home and about keeping their floors clean. Which may be more important, especially in dense locations, than we might be realizing.
No, there's evidence of it on half of the soles of ICU workers' shoes, and they found the virus on the floor of areas where patients were not found. From this they proposed that within the hospital, shoes could be a vector and highly recommend that people disinfect shoe souls before walking out of wards with Covid-19 patients.
There are not any reported cases of the virus infecting anyone by shoe though.
I’m confused/concerned by this as the US authorities are emphasizing that this is a respiratory virus and no need to be concerned about food transmission, etc
The best evidence is that there's no need for the average person to be concerned about food transmission. The hospital context is very different; transmission routes that are normally negligible can start to matter when you have 200 people coughing coronavirus into the air.
They tested in hospital/ICU areas. I think the odds are much higher in such an environment. Obviously medical workers should keep from transferring viral material to their homes, but to imply that this is being transferred by non-medical personnel is inaccurate.
Definitely there is more of the virus in hospitals and in the ICU. The virus is also probably on the floors of subway cars, elevators, and other public places if someone infected emits droplets in those areas.
Of course, I'm only suggesting that the idea of shoes as vectors might be something.
We are richer per capita, the large population of the U.S. should give us economy of scale (for software development etc), and the lower population density should mean less contacts to trace per case. There's no excuse. We passed a 2 trillion dollar coronavirus bill and there's no contact tracing army? Madness.
It's infinitely cheaper than shutting down the economy and the massive ensuing bailouts.
"on the street observations in the article are: masks, masks, masks. "
There is no evidence that masks are a solution.
Just the opposite: contact tracing is definitely a primary driver of success.
We should have enacted aggressive contact tracing and widespread testing a long time ago, and recommended 'surgical/cloth' masks for public but strongly discouraged N95's as there are limited quantities and those need to go to the front lines.
Masks are not meant to solve/prevent Corona. It's meant to slow down the spread of the virus. It needs to be used in combination with other measures such as social distancing.
Unfortunately the Dutch government keeps saying that masks do not help, sometimes they suggest that a mask can make things worse. The reason behind this seems to be to prevent people from stealing masks from hospitals, something that seemed to have happened in every country.
That said, please check the effectiveness of masks. It doesn't need to be perfect, just slow down the spread.
Do we know yet whether the clusters of fatalities among families are due to higher exposure rates or some genotypic susceptibility to the worst effects of the illness?
Or is that just that the family clusters are good news copy (ugh) and over-represented?
Spouses wouldn't necessarily share any genetic susceptibility yet there are plenty of stories of husband and wife pairs dying. Whether these stories are over-represented, like most areas of "proof", is pretty much impossible to say for certain at this point.
You can't top mitigation/supression until there is herd immunity.
You can get the immunity only two ways 1) enough people have been gone trough the disease or 2) vaccination.
South Korea must use mitigation/supression until they have enough people vaccinated or it flares up again. Complete eradication without immunity is not feasible unless you isolate whole country from the rest of the world permanently.
You don't have to completely isolate the country from the world. You just have to do testing and quarantining to ensure that infectious people and things aren't entering the country.
However, the latest cluster in Heilongjiang involved an asymptomatic student returned from USA, completed 14 day quarantine, tested negative before and after, but still went on to infect her family and neighbors who infected more at the hospital. Total confirmed cases in this cluster is ~50 right now.
Most of the spread in this case happened because of negligence in the hospital thinking coronavirus is eradicated there so they didn’t take precautions. Coastal cities like Shanghai are taking good measures so there hasn’t been a problem despite it being where most international flights land and basically 100% back to work for over a month now. The biggest danger is people becoming tired of wearing masks and avoiding gatherings over time.
Sure, but keeping up testing, contact tracing and other South Korea-style suppression measures is no big deal compared to the severe restrictions most other countries have had to implement. It's very troubling to shut down the economy for a whole year, but it's certainly plausible to sustain those measures until a vaccine is ready.
You can still trade with the rest of the world - people are still doing that now, in fact, with international trade being universally exempted from travel bans. But I can't imagine tourism or business travel being compatible with the level of quarantine required to keep an endemic respiratory virus eradicated within your borders.
Very surprised to find out country (city) in HN's top page!
For people who are interested in current Korea's situation:
There were 18 new cases two days ago, and 8 new cases yesterday.
The number of new cases have been consistently falling since April 14th.
'Intense social distancing' was stopped yesterday (April 19th),
and the Korean government is planning to drop the 'social distancing' policy on May 5th.
Schools are planned to open on May 6th, and the ban of churches, bars, etc. are expected to be dropped in the following days (probably tomorrow).
The KCDC is saying that to drop the 'social distancing',
there should consistently have less than 30 cases (which is true for a week)
and cases which infection routes are unknown should be less than 5% of all new cases.
(It was about 5%~10% when it was announced, and AFAIK it's now true.)
There's still some anxiety because people started to become dull to the social distancing movement - so people are worrying that new cases might increase.
What about international flights? Are airports in SK still closed? I'm pretty sure they will have to limit traffic into and out of the country despite easing social distancing.
Otherwise, won't there be a new wave of infections when they let 'outsiders' back in from places where the virus is still running rampant?
> What about international flights? Are airports in SK still closed? I'm pretty sure they will have to limit traffic into and out of the country despite easing social distancing.
Airports in South Korea has never been closed - South Korea has never banned anyone coming & going outside. A quarantine of two weeks became mandatory since April 1th, but South Korea has never closed Airports or has done a lockdown.
> Otherwise, won't there be a new wave of infections when they let 'outsiders' back in from places where the virus is still running rampant?
Definitely that's a concern, 5 out of 8 new cases yesterday were people that were infected from foreign countries. However since South Korea has never closed it's airports, people generally think it's controllable(like it always was).
> There were 18 new cases two days ago, and 8 new cases yesterday.
> Korean government is planning to drop the 'social distancing' policy on May 5th.
Are the people divided about whether it was a good idea to wait until new cases got this low before making decisions about moving forward? Or is there very broad support for the kind of discipline it takes to wait until May 5 despite the cases being so low already?
Have people's opinions about the appropriate level of response become politicized? Have the facts and statistics and science of it all become politicized?
> Are the people divided about whether it was a good idea to wait until new cases got this low before making decisions about moving forward?
People are generally agreeing that it's a good idea to wait b.c. they also think that there's still the possibility that a new wave of outbreak can happen.
> Or is there very broad support for the kind of discipline it takes to wait until May 5 despite the cases being so low already?
The policy of dropping the 'social distancing' was decided by the KCDC (consistently have less than 30 cases / cases which infection routes are unknown should be less than 5% of all new cases) on April 12th when the count has dropped less than 30 for the first time.
The government is still saying that if a new outbreak happens within the next two weeks, the day might be pushed back. It's still very elastic.
> Have people's opinions about the appropriate level of response become politicized? Have the facts and statistics and science of it all become politicized?
It's only targeting the people of Seoul, but 97% of all people agreed that the 'social distancing' policy should be dropped sometime soon, but 64% also agreed that April 19th was too fast - hence the May 5th decision.
As GP said in another reply, the incumbent party won a landslide victory in recent congressional election (180 out of 300 seats), so it seems South Koreans generally approve how the government handled it. (Of course the timing was fortuitous for Moon: had the election happened ~45 days ago things would have been very different.)
Even for the opponents, it seems the majority criticism was that the government didn't do enough - somehow they're very angry about not blocking visitors from China. (Many conservatives have a strong pro-America, anti-China sentiment, and frequently accuse the president of being the opposite.)
You don't have to be a conservative to see how the gov't screwed up early on -- the SK gov't went against the advice of the Korean Medical Association to restrict travel from China; instead the current Moon administration made a political decision to keep their door open to China to please Xi JinPing of China. The problem for the minority party was their link to Shincheonji, a cult responsible for the majority of all coronavirus cases, and they really had to keep their head down pretty much throughout the whole ordeal.
I consider myself a newbie and neutral on SK politics and had dismissed all the criticism of Moon being a commie and all before, but I'm starting to see through the garbage now.
Well, AFAIK, expert opinions were divided: many doctors were against border closing, saying that it will cause more people to enter illegally and hide, and then we'll have a harder time tracking them. (It's just a short boat ride across the Yellow Sea from China: you can't block the entire coastline.)
We may argue which side was right in retrospect, but it's not like Moon ignored the expert consensus.
Besides, Korean Medical Association is not exactly a neutral expert organization. The current head of KMA is this guy here [1], with pickets reading "Impeachment is void! Stop framing innocent President Park! Let's rescue innocent President Park with people's power and restore her honor!" blah blah, referring to Park Geun-Hye, kicked out in 2017 after corruption scandal.
There was the election of the National Assembly on April 15th, and it ended in an overwhelming victory for the party of the government. IMHO COVID-19 has shown how the current government is different to the last government that handled MERS - which was impeached (the percentage of supporters have greatly increased during the COVID-19 outbreak).
South Korea demonstrated from the beginning on how to deal with this (despite their slow start - which still is super quick compared to most western countries).
But its completely wrong to think they passed it. They also have massive impediments at the moment. Back to normal? Far from it.
I am stuck in my flat in Spain for the 5th week now. Just read they extended it another two, to 8 in total. I am wondering how other countries can be a bit more relaxed (UK and Belgium are allowed out for an our for exercise), or in the case of Sweeden a lot more relaxed, and are still managing to flatten their curves.
There is no evidentiary basis for the extreme lock-down Spain is using.
While this disease is pretty contagious, you are pretty unlikely to get it walking around outside or going for a run. Especially if everyone is wearing a mask.
It's possible you could catch it by running through a cloud of an infected persons breath, but the risk is low enough that we shouldn't ban outside activities.
The vast, vast majority of infections occur from sustained contact (>15min) within a few feet of someone.
This is an ancient understanding though, it ignores aerosol transmission. But you are still correct that outside is safe, there is absolutely no need to restrict it at all, it's confined poorly ventilated spaces that are a problem, like almost any building, cars, buses, planes, where the virus can concentrate in the air and close range contact isn't even needed, just breathing such air is bad enough. Wearing a mask is the only thing that helps to not get infected in such situations, but doesn't actually help much when infected people are wearing them, they still contaminate the air with aerosol.
This is something I have not seen discussed or explained anywhere:
Spain has such a hard lockdown and yet even after 5 weeks there are still thousands of cases every day. How are so many new people getting infected? The same has been true in Italy.
It's extremely difficult to tell whether the number of cases are increasing, or if testing is revealing more cases. It sounds like a tautology, but unless you have a very strict, consistent testing rubric, the outcomes are hard to measure in terms of growth. At best you can determine total case count.
Household infections. Infected person in its infancy of the infection gets locked down with the familly and they get infected too. So you must go through all of that for the numbers to slow down and fall.
I've wondered this too. I can only assume it's because they send infected patients home, and they spread it to their families. That and hospitals & nursing homes, where infected staff may be spreading it between the patients/residents?
If people are having less social interactions per day, on average, it will still slow down the spread compared to everyone behaving as before. There's a continuum between no measures taken and complete lockdown... I'm personally very much looking forward to being able to see friends.
If people really stay apart from each other when exercising (anecdotally that does seem to mostly be the case here in the UK), then it's not really going to spread the virus in any meaningful way.
The original guidance in the UK was to limit exercise to one hour but the actual law doesn't have a time limit.
From what I see, people are generally behaving responsibility regards social distancing and, I assume, this is just a gamble our Govt took?
Without making sweeping generalisations also, it isn't so common for young adults to spend much time with parents/grandparents/older relatives. So, I reckon, that's one big risk factor that is less of an issue here?
Some reporter asked Matt Hancock how long was a reasonable length of exercise, and he suggested half an hour to an hour for most people - that's probably where it came from. It's not official guidance and certainly not a hard and fast rule anyway. From what I recall the once a day part is also only a guideline and not actually the law in most of the UK (except Wales).
>> The actual fatality rate of Covid-19 is the region of 0.1%
> How can we be sure until we have widespread testing?
I think we can be sure that this is an incorrect number, with the data we have right now. At least 8448 people have died of COVID-19 in New York City, and if only 0.1% of the infected die, then we have 8,448,000 infected New Yorkers. This is the entire population of the city (including those who fled to other states) and would mean that we've reached herd immunity and can stop worrying about it now.
> At least 8448 people have died of COVID-19 in New York City
Just to add: be very careful to compare deaths across countries. Every country seems to count deaths differently. Some only count it if you didn't have any other condition. E.g. you had something with your lungs? That death might not be reported.
In Netherlands they compared the amount of people dying per week. There was a sudden huge increase of deaths. It seemed to indicate the number of deaths for Netherlands was 2x as high as they were reporting. Though they did report the deaths with a very clear remark that the numbers were highly likely to be too low. Unfortunately such remarks were often ignored by the public, leading to eventual distrust of any figure. Interestingly, the press at various times did make it clear that the figure could be unreliable. Seems people often just read a headline :-p
PS: My point is that the 8448 might be greatly higher. Depends on how the 8448 was collected/reported.
>it's a fair bit nastier, certainly in some cases, or the hospitals wouldn't be full
While I agree that it probably is indeed nastier than your average flu, it actually wouldn't have to be much nastier to achieve health system saturation in places where it hits groups that are particularly vulnerable (the elderly mainly). Almost all healthcare systems operate on fairly thin margins of tolerance for overload, and a virus of even mild percentages for hospital-worthy or lethal cases could easily, temporarily overload clinical infrastructure if it comes out of the blue and is moving through a population that was entirely virgin to it before the infection in question arrived. This lack of immunity among all parts of society means massive numerical surges in cases very quickly and consequently, major numerical surges in that small fraction of cases that end up being bad enough to warrant hospitalization.
We won't be sure of such statistics whether or not we have widespread testing. Even for pandemics in the past, we just don't know how many people caught them, not even a single significant digit. The best we can do is make reasoned guesses based on the available evidence.
I recommend watching the whole video, as it is by far the clearest argument in favor of the "herd immunity" approach I've seen.
The problem with the approach is that it assumes several things that, shall we say, there is not yet evidence for.
1. The disease is relatively mild, certainly less than an order of magnitude more fatal than influenza.
2. It is possible to protect older people and other vulnerable populations while the disease spreads through most of the rest of society.
3. After people recover from the infection, there is lasting immunity.
If these three things are true (and some other things that I'm not going to argue with, including that it will take a long time to get a vaccine), then herd immunity is a reasonable strategy. But let's look at each in turn.
1. The death rate in New York City is already 0.1% of the entire population. Even under very strict assumptions, that we're exactly at the peak of a totally symmetrical curve, and that herd immunity results in 50% of the population being infected, that results in a lower bound of the IFR at 0.4%. Lombardy gives similar results (0.12% of the population directly attributed to Covid-19)
2. Prof. Giesecke admitted that they failed to do so in Sweden. It is not clear how this could be done, as elderly people do not live in a bubble, but rather have lots of workers coming in and out of the facility to help take care of them.
3. SARS-CoV-2 is a new virus, and we just don't have the data yet. You can extrapolate from existing coronaviruses, which suggest that immunity will last at least a year for most people, but there are worrying signs (low antibody production, reports of reinfection that might or might not be testing artifacts). We just don't know.
To me, it was a gamble, and we'll know before long whether it pays off. There were some things that bothered me about Prof. Giesecke, such as his dismissal of the experience of China ("it's a different world"), and other things that made a lot of sense. People who want to believe will be citing this video as authoritative support for their beliefs. If these assumptions turn out not to be consistent with evidence, then people will be citing this video as a case study in how smart people can get stuff horribly wrong.
Every one of the “reports of reinfection” I have seen was along the lines of: tested positive continuously for 2 weeks, then tested negative twice, then tested positive again a couple days later. There is no evidence in any of the cases I saw that the person was exposed to another infected person during that time period.
This should not be called “reinfection” (even though there are a bunch of sloppy media headlines calling it that) but rather “poor test sensitivity during the last stages of the infection”.
About 1. not even counting death, we don't know what the long term effects on the lung capacity of the people who recovered are. Also, everyone reports "80% of mild cases", with a definition of mild that includes things that reasonable people would definitely not call mild. Essentially, as long as doctors don't tell you you have to be on O2, you have a mild case. People with mild cases may well end up with damaged lungs.
Yes, that is the main issue with our strategy in Sweden. We failed to keep it away from seniors' homes. The strategy seems to have worked just fine otherwise. It stopped our hospitals from getting overwhelmed, espcially since we managed to contain it in Stockholm for the most part. But we did not have resources to test people working with the elderly.
it's even worse than not testing enough in care homes: "Its advice to the care workers and nurses looking after older people such as Bondesson’s 69-year-old mother is that they should not wear protective masks or use other protective equipment unless they are dealing with a resident in the home they have reason to suspect is infected."
https://www.theguardian.com/world/2020/apr/19/anger-in-swede...
The responses in the US, UK and Sweden (and probably others) are downright criminal and should put politicians in jail.
It is expected that 70% of the population will get coronavirus then we will have herd immunity. The lock down is about stopping the healthcare systems getting overwhelmed (that will cause unnecessary deaths). That's the way I understand things.
The same number of deaths will occur are likely to occur in the long term unless Sweden's ICU beds get full.
If anyone has an alternative interpretation I am open to hearing it.
According to healthdata.org (IHME), Sweden has 79 ICU beds. If this is true, it seems that slowing the curve may not be worth it with so few ICU beds available.
I don't think the number of deaths in Sweden (around 1500) is that high. Sweden has 10 million people. Some sources report it as 10% (of all cases), but I would be very cautious with these numbers. We know since quite a while that the number of reported cases can only act as an upper barrier, which may be between 10 and 15 times too high.
In Germany you are only tested under some conditions. I know many people that had quite a few symptoms and have not been tested even though they wanted to get a test. Only the ones that got severe problems or had relatives with a positive test. The conclusion is that we only know the death count quite well, the rest is mostly guess work.
When this is done and everyone is vaccinated, Sweden will have at least 5x the number of deaths per capita of their neighbors in the west and southwest. And the people of Sweden will still have strong support for their authorities' decisive response to the epidemic. My prediction.
How would this be possible? Do you believe that less than 50% of the population will get it outside of sweden? The lockdown cannot continue for a long time. The lockdown is just pushing the time frame by a few weeks. In the end the same percentage of the population will get it everywhere. Locking down is a short term solution to stall the contagion while the health system gears up to deal with it.
They had really good contact tracing. I'm not even sure how much we're attempting this in the US. "Lockdowns" without contact tracing is taking the path of "herd immunity for essential workers"
That's because they intervened early with large scale testing, contact tracing, and social distancing.
The problem is contact tracing only works when the number of new infections is manageable, though. That's why it's so critical to react early and aggressively. Once it becomes unmanageable, the only solution is mass quarantines until the numbers are manageable again.
The best analogy is a fire. If it's just embers, one person can stomp it out. If you wait for it to become a forest fire, then it requires drastic measures.
Clearly we (in the US) need quarantine now when things are out of control (and we need adequate PPE equipment for those working and financial support for those not working, two things that seem to be failing, likely to our extreme detriment).
But once the "fire" has burned far enough, we will testing and contact tracing. And so we need to be getting these up and running NOW so they will be ready when the "fire" has subsided sufficiently (and hey, we are failing on this too).
There doesn't seem to be much of a plan in place to test and contact trace in the USA. As you said we need to be getting these up in place now. And they should already be in place in areas without a lockdown.
But I don't see much evidence we are really trying to do that.
I also wonder if its possible to test and trace if its every minor city in the country in low numbers. We will have a million patient zeros.
The coordinated mainstream media. Again, the narrative is if you think the US media is partisan you’re a Trump supporter.
The entire US media ecosystem is owned by only 6 companies. It used to be hip to distrust the media but now it makes you a Trump supporter or conspiracy theorist??
It's never been easier to spread your message to the world, so I would think that the "true", honest, good, non-evil, non-coordinated mainstream media would also exist in some form. Where are they?
Independent journalism has never been better. Personally I don’t get my news from “retired” intelligence agents and CIA directors, but I guess I’m a conspiracy theorist in that way.
Well, when even some FOX journalists realized that Corona was something to take seriously; and Rupert Murdoch suddenly cancelled his birthday celebration (no non-family guests).
The truth is discovered by following both sides of the argument.
Because the indisputable facts are ignored by Trump and his supporters.
The US had a small, dedicated team to track animal-based infectious diseases (Predict). The Trump administration cut funding for it and it was dismantled last year. This dismantling was purely for
ideological reasons.
South Korea—an extremely market driven and democratic nation—also has nationalized health care.
This means nobody has to wonder if they can afford testing because the leaders understood what was at stake. When Pence was asked this question, it was regarded as a political potshot by the journalist and dismissed out of hand. I remember this clearly, as I watched this in real-time when I was getting a haircut.
South Korea took MERsS and SARS to heart and kept its experts in place; allowing SK to assess the danger rapidly. They too had their conservative party fight tooth and nail to make their administration (liberal) look incompetent.
Meanwhile Trump supporters have insisted for months and still do. that this was mostly a liberal follow-up to a failed impeachment.
The difference between how SK coordinated and how the US did not cannot be ignored, and a key difference is that the administration in
power didn’t view their experts with suspicion as deep-state or as a money-sink for third-world-only issues.
At every step Trump has shown that he does not nominate or keep anyone due to their competence in their field.
There’s no dispute about these facts. Yet anyone who views current events with suspicion only has innuendo to back their position.
Therefore, calling out anti-journalists for what they are is well-deserved.
“South Korea's foreign minister, Kang Kyung-wha, speaking to the BBC last week, said the key lessons from her country are that it developed testing for the virus even before it had a significant number of cases. "In mid-January, our health authorities quickly conferred with the research institutions here [to develop a test]," Kang said. "And then they shared that result with the pharmaceutical companies, who then produced the reagent [chemical] and the equipment needed for the testing."
> U.S. has swelled to more than 700,000 while Korea [...] have slowed to just over 10,000.
Comparing absolutes is not very useful so I thought I'd double check this. The difference is obviously less when normalized but the US is still an order of magnitude worse than SK:
South Korea: 234 deaths 8042 recovered. China: 4632 deaths, 77k recovered[1]. Their treatment protocol is an order of magnitude better than every other country. What are they doing that we're not? This is a huge glaring discrepancy. What's the difference between their treatment protocols and everyone else's?
What's the difference between their treatment protocols and everyone else's?
It's mind boggling anyone has to ask now this has been going on so long but here goes.
1) They had an approach plan beforehand because they had observed the previous SARS epidemic and took the danger seriously.
2) They had "quarantine hotels" freely available for those who were positive to prevent them from infecting others. (Seattle has a few of these, I've heard but they aren't widespread in the US. The idea of housing people freely is anethema to the US.)
3) They did testing early and often.
4) Their doctors and nurses worked with full PPEs, full anti-contamination suits, so they didn't themselves massively spread the illness.
5) They reserved hospitals specifically for the epidemic and had protocols for sending people to these hotel.
6) They had drive through testing and other testing easily and freely available (the US plan of profiting from testing is just so "I can't even").
7) They did systematic contact tracing with an app for people to discover where infectious people had been.
8) They did social distancing with mask from the start.
-- The US had literally done NONE of this. What the US has done is last-ditch efforts by states after the ostensibly responsible parties (the CDC etc) failed massively. And the Federal government is now literally sabotaging the states.
The thing I don't get is this explains how people didn't get sick. What it doesn't explain is how so many got better after getting sick compared to other countries.
The fatality rate of countries with active epidemics is skewed by a variety of factors:
- With exponential growth, most cases will new and so not become potentially lethal. This can lower the observed fatality rate (I think this explained Germany's original "great" rate which doesn't look at great any more).
- With cases rising quickly, most countries don't have infrastructure or the time to increase testing (US testing is failing on multiple levels but even France, Spain and Italy are just overwhelmed with the sick and testing is less important).
- With cases rising quickly, the fatality rate increases as hospitals are no longer able to provide adequate care.
- Different countries have different age-profiles and the disease hits the elderly harder (but once hospitals break down, the odds for the young decrease).
South Korea's fatality rate is similar to the ostensible fatality rate of Turkey and Luxembourg but likely for different rate. We probably won't have a complete idea what's happened until these events are done.
Well, their CFR is currently around 2%. I tend to think this will be roughly the best that can be achieved considering their investment in both T&T as well as an excellent healthcare system.
If you are effective at preventing the spread, then you can get lucky in terms of protecting the more vulnerable. I'd love to see some demographic breakdowns of deaths/infections in SK to see if they mirror the general population, or skew a different direction.
The "recovered" numbers in other countries aren't even close to accurate.
Countries with large outbreaks are only testing people with severe symptoms. Korea is testing anyone who comes near someone with the virus. So are catching close to everyone who has it.
Western countries most likely still aren't testing mild patients.
SK and China went for full containment: every single positive case is hospitalized and close contacts are quarantined in hotels so few cases are missed.
While in New York, hospitals are focused on saving critical patients. If you test positive but have mild symptoms, you are usually let home anyway so it doesn't really make sense to test most people who would be taken very seriously in Asia.
Yes, but once the outbreak is at a low enough level, and you have sufficient test bandwidth, you can manage it via testing and tracing. Everyone who gets sick, with anything, gets tested (in some variants of the plan every everywhere gets tested every N days). If you find a positive, quarantine them and test everyone they came in contact with. Repeat.
This reduces the rate of spread by catching community transmission before the end of its cycle. And it's worked with other outbreaks in the past. But it depends on having a very large available pool of rapid testing, so you can't do it when you have thousands of cases per day. But a few dozen... probably. It definitely seems to be working in Korea.
But again, it only works once the outbreak is well contained. Stay home.
The trouble is, reducing the size of the outbreak doesn't affect the number of tests needed to do this much at all, and the number of people South Korea has been testing doesn't seem to have increased in quite a while. In fact, it seems to have actually decreased compared to back in March. Like, as far as I can tell, they're still using the same contact tracing and testing strategy that failed to contain it before without additional strong social distancing, and the social distancing is weakening.
> But it depends on having a very large available pool of rapid testing
Not necessarily. You can just aggressively quarantine - basically the strategy in China.
> so you can't do it when you have thousands of cases per day
At what scale? Iceland was able to do it with ~200 new cases per day per million. The majority of US states haven't had spikes this high - nowhere in CA has even come close to that.
Iceland's per capita new infection rate peaked higher than basically any nation in the world, and while it's dropping comparatively rapidly it hasn't reached a stable baseline yet. I don't think this is a good example at all.
While it's clear their lockdown "worked" (in the sense of recovering them from a disastrous peak), I think it's still very much an open question as to whether their testing capacity will sustain this success.
Through mass testing they already avoided one nursing home hit, and haven’t had a single hit. If they do, their fatality rate could quadruple because of how small the numbers are we are looking at there.
This article for example was on the CNN front page, explaining that the major bottlenecks are test swabs and the required reagents and describing a specific FDA action which the governor of Ohio thinks would solve his problems.
The US was disastrous at testing initially, but now they are doing a lot of tests (several million). Unfortunately given the stage they are at (infections widespread, still no national lockdown, some states opening up again because they think it's all over), it's too late for test and trace.
> some states opening up again because they think it's all over
This is unequivocally not why some states are preparing to relax the so-called "safer at home" orders. Waiting until "it's all over" was not the goal of safer-at-home. Flattening the curve in order to prevent an immediately overwhelmed healthcare system was the goal. In multiple US states, the curve is acceptably flattened (or is expected to be in the next few weeks), and hospitals have plenty of available capacity. Those states are going to continue encouraging physical distancing, good hygiene, etc. while allowing closed non-essential businesses to resume limited operations.
> Waiting until "it's all over" was not the goal of safer-at-home.
Someone should tell that to the Italian authorities. At least until recently, some public statements seemed to inch in that direction ("zero new infections"), although more recently they realized that this is hardly possible at this point (especially if the estimates of the actual vs effective cases are true - talking about at least one order of magnitude).
I'm watching Italy/Spain with great interest at this point as both are loosening restrictions (after going through the same sort of hell as New York). If they don't see a new bump up in a few weeks for them, it means prevalence is far higher than we think in those countries (good news for them).
So far in Italy nothing will change until May 3rd. But the government is in total chaos over this (mainly because they're afraid of death themselves...). Lots of very unpractical ideas to keep distancing from so-called experts, too.
I guess we'll have to see what happens. Personally, although I'm very aware of the risks and will prepare accordingly, I'll be glad if I can finally get out of this isolation.
If you haven't even started the curve (as many of these states haven't), then you're not flattening it by using stay at home for a short time then relaxing it.
IMO loosening restrictions without really aggressive testing and case tracing is going to undo lots of good work by other states by allowing the virus to spread, but time will tell.
On a per capita basis yes, but the US has done more tests than any other country. Once the US doubles testing capacity again it will be on par with other large countries.
I guess after their bandits have stolen testing kids destined to other countries just like the bribed people with suitcases of dollars get masks enroute to various European countries.
I am hoping for the best for the US, but I am quite offended by how the US is scrambling to undo its own mistakes by steamrolling everybody else.
What this effectively means though is that we are still tightly scoping who can get tested in the US. My mom is a primary care provider in the DC suburbs, and their hospital system is still limiting tests to medical providers and first responders. People who "obviously" have Covid-19 are just treated, and mild cases are sent home without testing.
Sure. On a per capita basis the US is ahead of SK. To reach Germany levels the US will need 8M+ tests. That’s a large percentage of all tests that have already been done worldwide. Unfortunately a large country like the US (similar to countries like China and India) is going to run into production/technology constraints.
The US dropped many balls and started late with ramping testing in particular, but now the ramping is happening and just takes time. There was also no way the US could test enough people using the original set of tests that simply took too long. New technology had to be developed.
> Unfortunately a large country like the US (similar to countries like China and India) is going to run into production/technology constraints.
A large country has a lot of people to test, but also a lot of people to manufacture and perform the tests. So that argument doesn't work for me. Especially when we're talking about the richest country in the world.
Now, if the test making and executing is done by a single centralized organization, it does make some sense. Which is why that way of doing things is an anti-pattern.
I've been watching quite a lot of US mainstream media these days and I can confirm that this is not true.
For all of MSNBC's faults, their anchors have been repeating testing like a broken record. They even mention how much they sound like a broken record but that testing is simply the most important thing in reopening, and that the US is doing very little of it.
They and others discussed the issue enough to make your original statement false, including questions like "Why isn't testing ramping up?". That's the point I wanted to make. I'm not really looking to find timestamps and links for you when you haven't even done a cursory search before stating that no one was talking about testing.
Eventually, but an immense amount of capital (not just in a cash sense) that allows those businesses to operate has been irreparably destroyed. Rebuilding and bootstrapping that again from almost nothing will take years in many cases. Businesses don't exist in isolation, some sectors are seeing destruction not just of the businesses but the entire institutional structure of their ecosystems, which is much harder to replace.
There will be second-order effects that people aren't considering. In Seattle, for example, all of the builders I know are saying multi-family residential construction projects have become indefinitely non-viable due to the systemic collapse of the business ecosystem they rely on. Even if things opened up tomorrow, most of their projects will stay dead for the foreseeable future. This will have a large impact for housing costs, construction worker employment, etc many years beyond the term of the lockdown.
I think many people are oblivious to the long-term second-order damage that is being inflicted in some industries that cannot be fixed on any kind of timeframe that matters to ordinary people.
I'm not. Plenty of countries have shown that we can reopen without killing those at risk. The false choice of saving the economy vs saving the at-risk is an entirely political position and part of the propaganda machine you've fallen for.
Unfortunately, in the US, the federal government has presented the false choice of safety vs economy. Yes there are trade-offs in tactics, but it's not one or the other. Stop playing politics, unify messaging, and increase spending money on both. I'm helping organize projectdomino.org as part of staving off the currently-likely upcoming shitstorm of reopening without public health funding, coordination, infrastructure, and compliance. I encourage aiding local causes and telling your local Republican leaders that you're tired of their shit that has now stepped up to pathogens literally attacking us at home.
how was south korea able to scale up their testing so fast. Where did the extra testing capacity come from. I've been really curious about this but haven't seen any good answers so far.
It is am extremely stark example of the value of maintaining manufacturing capacity in your country. Korea can makes tests, so they have tests.
Seegene, a company that makes Covid-19 testing equipment is in Korea. They just needed approval and to ramp up manufacturing. For most countries, like the US, we don't have the manufacturing ability anymore, so we have to go beg and buy tests while we figure how to make again. Seegene alone has been responsible for 80% of the tests in Korea.
Not so long ago, East Asia was hit by another epidemic virus. So they are better prepared than many other countries. They have reserved workforce, researchers, and labs to deal with it in South Korea. Therefore, they were able to mass produce fast test kits so quickly.
The population is also better prepared for this situation. They still remember it and know they have to follow all the advice coming from government and health experts.
Even before the spread of Covid-19 outside China, all East Asians started to use face masks. I'm not saying mask helped them, I mean that just shows how their society still remembers the last time that they were hit by a virus.
Afaik, the shortage in US is mainly of raw materials and commodity items like pipettes. How did Seegene ramp up its raw material pipeline so quickly. Really fascinating success.
Korea has a broad swath of medical manufacturing capacity. A large part of the supply chain is already there, so it is easier for them to ramp up. You can double or triple output just by putting more shifts into the factories. Then you start retooling, repurposing to really ramp up.
The US could have ramped up production, but politics and regulation prevented it. The CDC and FDA prevented any private companies from producing their own tests and in the meantime the CDC made their own small batch of tests that weren’t even accurate. If the president had taken the outbreak seriously we could have begun test production immediately, which is what South Korea did the moment they heard about the outbreak. This is largely due to systems put in place during and after the SARS and MERS outbreaks.
South Korea has far superior legal framework for pandemic compared to most western countries. As soon as there is a sign of a beginning pandemic, the medical professionals automatically get a massive increase in power and can start enacting lots of policies regardless of what politician think.
They where probably better prepared as well. Preparedness varies a lot. In the Nordic region where I am from the Finns have done better than the rest of us because they are a prepper nation. They constantly prepare for the worst.
Finland has enormous bunkers under their cities that can hold the whole population with air filters, water, food stock piles etc. Finland has massive stock piles of medical equipment, even stockpiles of raw materials for making ammunition medication etc.
In many ways I think it has paid for them to not be NATO members. They know they are alone and have to take care of themselves just like in the winter war against the Soviet Union.
In Norway I think we place too much faith in NATO. If it was up to me I would get the hell out and focus on self reliance instead.
> In the Nordic region where I am from the Finns have done better than the rest of us because they are a prepper nation. They constantly prepare for the worst.
I am sure the Finns have done a fine job, but I don't think one can say that "the Finns have done better than the rest of us because they are a prepper nation" without studying this in detail. Being prepared is important, but just one part of the equation.
Travelling is also another important part (I am sure there are many others as well).
Looking at passenger statistics, the Finnish population seems to be traveling less by air than most Nordic countries as well. I have not extracted domestic flights and if flights are done by the citizens of the country where the airports are located, so these numbers are ballpark figures, but I guess they can give some insight (although domestic flights might cause more rapid spread of virus as well).
Looking at the five biggest Airports in each country in: Finland, Sweden, Denmark, Norway and Iceland, I get the following passenger numbers for each country per year:
Iceland: 21,7 flights per person, per year.
Norway: 8,5 flights per person, per year.
Denmark: 6,2 flights per person, per year.
Finland: 4,4 flights per person, per year.
Sweden: 4,4 flights per person, per year.
The passenger numbers correlates relatively well with detected cases when the pandemi hit the Nordic Countries (chose March 4th, arbitrarily); Sweden and Denmark changes place:
====
Iceland – March 4, 1]:
Coronavirus cases detected: 26 cases
Population-size adjusted, up to the size of Sweden (biggest country): 730 cases
====
Norway – March 4, 2]:
Coronavirus cases detected: 59 cases
Population-size adjusted: 109
====
Sweden – March 4, 3]:
Coronavirus cases detected: 52 cases
(Not Population-size adjusted)
====
Denmark – March 4, 4]:
Coronavirus cases detected: 14 cases
Population-size adjusted: 25
====
Finland – March 4, 5]:
Coronavirus cases detected: 7 cases
Population-size adjusted: 13
====
So when this awful pandemi is over, I think it is important to study all aspects of what happened in each country before one draws firm conclusions. And LEARN from the good stuff, and do more of that! :-)
They took a long time to decide it was a national priority. At the point when Korea started heavily ramping up its testing program, most Western countries took roughly the same approach they took during SARS, where they contact traced and tested only the few cases they knew about with the expectation that'd be enough.
I am unable to find any reliable data that shows the ramp up of testing capacity after deciding its a national priority by country. What is the basis for 'similarly quickly' ?
Sibling comment to your original comment seems to suggest US wasn't able to 'similarly quickly' due to lack of onsite manufacturing.
Even the article suggests this,
> The country was testing people for the virus at the fastest pace in the world
I can't find the data off the top of my head, but in the middle of March the US was able to ramp up from barely 1k tests a day to 100k within a week or two. It's my understanding that Germany went comparably fast.
"Korean officials enacted a key reform, allowing the government to give near-instantaneous approval to testing systems in an emergency. Within weeks of the current outbreak in Wuhan, China, four Korean companies had manufactured tests from a World Health Organization recipe and, as a result, the country quickly had a system that could assess 10,000 people a day."
Before the virus affected anyone in Korea the president brought together many heads of industry, and ramped up masks/testing/essential item production.
Won't this reignite the spreading of the virus? Like, they missed a few people who were asymptotic and not tested, and are roaming the streets with other people?
Almost certainly. Nobody realistically thinks that we'll be able to reach a steady state where new outbreaks never happen. But they were able to suppress the outbreak in Daegu, so there's reason to be confident they can do it again.
No, because they test people regularly and do accurate contact tracing. Thanks to a favourable regulatory environment and a profusion of capable people, South Korea scaled up testing and tracing capacity very rapidly. Furthermore, they were socially prepared to do the basic social distancing.
Also, Taiwan has done an excellent job, and they didn't need to perform nearly as many tests. AFAIK there hasn't been a single additional confirmed case in Taiwan for the last three days.
Taiwan also has a lot of preventative measures, i.e. mandatory mask usage in mass transit systems, government issued masks and mask rationing system, automated temperature checks at various public spaces, mask usage in schools, plastic dividers at restaurants... on top of that they have a very sophisticated scalable method of tracking people who have the virus and ensuring that they are abiding by quarantine rules via tracing the location of their cell phone.
In my city, people are still arguing whether or not people in the mass transit system should be wearing masks.
what are the arguments against wearing masks on transit? i’m no fan of masks, but wearing them on mass transit (of any kind) makes sense. lots of random people in a relatively small, enclosed, and cramped airspace elevates transmission risk materially (as opposed to wearing them outside, where it’s negligible).
Does it show the success of their approach? Given that new cases hit the hospitals 2 weeks after exposure it seems like it is far too soon to know that.
Also, over what timeline are we talking? South Korea has fewer deaths now, will that be the case in two years time?
I've seen a lot of articles lately drawing conclusions from the state of the world as it exists now. But this is a highly dynamic situation. Today's assumptions are next month's fallacies. We need more humility.
On the other hand, they have something like 65 re-infected people. Could it be that they have a different/new strain ?
Edit I don't see why the downvotes. It is easily fact-checkable. Those 65 persons were hospitalized for their symptoms, considered treated and released and about 2 weeks later showed symptoms again.
We need to wait until we have antibody testing to get a clear picture about this.
A theory is that these asymptomatic cases simply had latent virus in their nasal passages (thus testing positive), and not actually be building any antibodies from an infection.
Yeah - Id love to know if there are any cases where someone was sick enough that they were treated, recovered, and then got sick enough they need actual treatment again.
And public masks, good contact tracking, and they say gloves but hand PPE, like alcohol, also I assume a good isolation system that doesn't scare people but seen no reports on this.
Investing on making testing to be cheap and quick has however been something people missed, compared to pie in the sky things like vaccines.
Also compared to masks which are obvious but have been religiously attacked in the West.
> Bill Gates has literally been preparing the last 20 years to make enormous amounts of money on a forced vaccination program
Is this one of those conspiracy theories I’ve been hearing about?
Bill Gates’ foundation has been giving away money for decades. If you think he’s planning to make a bunch of money off “forced vaccination”, you’re stuck in the past — Gates doesn’t care about making more money, he cares about getting the respect of his peer group & broader society. He’s not going to earn money off this, he’s going to earn respect.
That has nothing to do with “forced” vaccination, and everything to do with (the perception of) saving lives otherwise lost to this virus. If he funds a real vaccine, whether forced or not, he’ll accomplish his goal.
Please, leave the shortsighted “greed” conspiracy theories off this site.
Perhaps it would indulge the conspiracy theories too much - but I'd kinda love to see an actual breakdown of how something like this could ever make him money. Think of the huge amount of money he has lost from this in the other businesses he owns and think of all the money he invested in this for decades he could have invested in other lucrative industries.
How much would he need from this supposed plan to even breakeven? Thirty billion?
These things usually break down with one or two questions that the person can't answer. Just like the 5G connection nonsense, if you ask how electromagnetic radiation in the spectrum that 5G uses has a connection to a virus (the most basic question possible) you will just get someone angry with you. It's almost fascinating how people can develop emotional attachment to something that fails a droplet of investigation.
I try with such questions and people still grip to their 100% nonsense claims even when you show them that they dont know what are they talking about and is not even logical for various reasons. But, I still mostly do it for other people who read or watch that and have still not fallen for dumb conspiresies so that they would hear a reasonable contraargument. We need more logic, reason and critical thinking in this world.
> how something like this could ever make him money.
It's really simple, less death from preventable diseases reduces poverty, and increasing the sustainable prices for Microsoft products and services. More revenue for Microsoft lifts stock price and billg's net worth.
Of course, the math doesn't add up if billg has to spend all his money to do it, and not just Microsoft reaps the benefits, which is why he's trying to get lots of other wealthy people to spend their money similarly --- then everyone who benefits can share the cost.
Your comment only appeals to people who already agree with you, therefore it’s useless. If you want people to take you seriously then you can begin by addressing any of his points rather than fixating on the word “money” as if that was his entire argument. I can’t see his comment because he edited it but I’m assuming he provided plenty of evidence such as the timing of Event 201 and its focus on coronaviruses. Maybe you can begin by convincingly addressing that. If you weren’t aware of Event 201 before reading my comment then you should stop sharing your opinion on this issue anywhere.
The original comment didn’t mention event 201, it was literally just about money and how Gates was doing all this to get more of it, but really — all event 201 shows is that a coronavirus-based pandemic disaster was extremely predictable, not that it was planned. War games in secret rooms help predict outcomes, they don’t cause those outcomes.
Smart people have been concerned about a viral pandemic of this sort for centuries, and yet we were caught unprepared. That’s the real tragedy.
Event 201 as in the pandemic preparedness exercise? And its focus on coronaviruses because of SARS and MERS? Is that really all it takes to start an entire conspiracy lol
I do not believe any conspiracy theory about Gates and vaccines or anything else. But his comment about voting for Trump if the other candidate raise his taxes too much doesn't support the non greed argument ( he reiterated it after saying he was kidding with a straw man argument).
https://www.youtube.com/watch?v=ZMMZ1Qzr1ag
> he cares about getting the respect of his peer group & broader society. He’s not going to earn money off this, he’s going to earn respect.
Whatever the case, you have to admit that you are taking for granted that his intentions are benign. There's no rule that billionaires have to be benevolent. There's a lot of soft power associated with a mandatory vaccination program but aside from that, the chipping that he is behind has an enormous (and dangerous) surveillance potential.
The man has the clout and resources to potentially install a physical, nonremovable beacon into people's bodies, and has spoken openly and repeatedly about doing so. How do you know he won't get drunk with that kind of power? A single man could, say, sway elections if he had access to just the location data for 300MM Americans. And there's really no way we'd know if the biometric/location data were being siphoned for "non government" use...
> you have to admit that you are taking for granted that his intentions are benign
Huh? I made no such assumption. I simply speculated that he was doing this for one form of currency, and not another. He may well want to track everybody, I have no idea.
But the whole premise is absurd. Bill Gates doesn’t need to inject tracking microchips into everyone through a forced vaccination program to “sway elections” — that’s Hollywood supervillain-level garbage: a massively intricate complex plan that achieves so little. It’s like inventing a time machine just to use it to prove to your friend that he really did say that thing he denies he said in 1972.
Bill Gates doesn’t need a crazy plan to sway elections — he can just buy tons of ads! He can fund others’ campaigns!
I don’t know Gates’ intentions — but I’m pretty sure he’s not stupid.
>But the whole premise is absurd. Bill Gates doesn’t need to inject tracking microchips into everyone through a forced vaccination program to “sway elections” — that’s Hollywood supervillain-level garbage: a massively intricate complex plan that achieves so little. It’s like inventing a time machine just to use it to prove to your friend that he really did say that thing he denies he said in 1972.
That's not what I'm talking about. You're conflating vaccination with the id2020 program. Different conspiracies. I'm just saying, if you implant an RFID digital certificate, you're effectively a walking uuid beacon. I'm not saying that's where he's going but the technology is there and his foundation is funding research into something like an RFID tattoo. Very easy to convince the masses that this is a necessary technology for safety given the new normal brought about by COVID19.
If I had billions of dollars I'd certainly be tempted to play worldbuilder. I very much doubt that he sees the masses as people - not out of heartlessness, but out of a necessary objectivity. They are statistics.
> I'm just saying, if you implant an RFID digital certificate, you're effectively a walking uuid beacon.
We already carry beacons in our pockets all the time, and the government is already a subpoena away from getting that data. What do injected beacons buy Bill Gates exactly? Whatever it is, it feels like a ton of effort for not a ton of gain, tracking-wise, given that the beacons we have already broadcast their location over a much larger area.
To repeat: don't take this as a sign that Korea believes it has successfully managed the outbreak.