I don't understand your comment. We made decisions based on information. The results of our original experiment turned out to be different than our expectations. Further, others were hurt substantially due to these decisions. Those hurt are requesting (or demanding) to change course so as to not be hurt further. Seems reasonable to change course, with each US State (or country) changing course differently based on their circumstances.
> Further, others were hurt substantially due to these decisions.
If anything the US government failed to act to attenuate the expected economic impact that emergency anti-epidemic policies would naturally have on the most vulnerable elements of society.
It's also very ironic, if not hipocritical, to abuse the most vulnerable and victimized elements of society, who have been systematically ignored and sacrificed , to argue against undoing policies aimed at defending society's best interests.
I don't know why you think we came out so far different from expectations - New York hospitals were overwhelmed, they hadn't shut down in time to prevent a large wave of cases - other locales that have gotten lucky or shut down have avoided feeling that wave so far... Changing course doesn't seem advisable as growth rates haven't subsided into the negative except in small locales.
New York was the exception to the rule. Most hospitals were not overwhelmed. In fact, many hospitals flirted with financial disaster when governors prevented elective procedures. I can speak specifically to AZ which outside of some very small Indian Reservation medical centers, is well below capacity[1]
Seattle's Army hospital closed without a single patient[2].
Growth rates, especially in AZ, were never large to begin with.
I would be cautious about using the past tense. New case rates have not come down much from peak - and I expect them to spike in the next few weeks as people let their guard down and things reopen.
Deaths lag infections by several weeks. Over 2200 people died yesterday.
I agree that with re-opening, we will see a bump in infections, and therefore deaths. However, there is only one path out of this and that is herd immunity. We can accelerate herd immunity via vaccine, but either way its herd immunity. That means that we want as many people sick as our hospital system can handle, but not more. That means playing a game of optimization. Further, different states (New York vs. Arizona) should have different plans because their situations are vastly different (population density, current herd infection status, etc).
Further, we can't just optimize for Covid19 deaths, we have to look at the whole situation, which includes suicides due to shelter-in-place orders, child abuse and other domestic violence, malnutrition due to hunger from unemployment, negative impacts of poverty.
this will certainly be a case study for future generations.
> That means that we want as many people sick as our hospital system can handle, but not more.
This would be the optimal situation, but it requires at least:
* Widespread testing available to any who need it for any reason;
* Careful, centralized monitoring and resource allocation;
* Plenty of PPE, critical care equipment, and disposable goods;
* A cooperative public willing to follow a constantly shifting set of recommendations.
And the country as a whole has basically none of those things. California is better-resourced and managed (for this particular thing) than other states, so they're gonna give it a shot. The rest of the country is just gambling.
This disease does not cooperate with this kind of response because of the lag time from initial infection to critical illness. Reports on this vary from like 3 days to 20-odd days. Coupled with the disease's high rate of infection, this means that a hospital can go from 50% full to 150% full very quickly. If a state government with an impossibly obedient population set a tripwire at 50% hospital capacity and shut everything down the minute they hit that mark, then they're still going to overflow a couple of weeks later as symptoms progress for those that were infected just before the shut-down.
The virus needs to be studied in further detail before we haphazardly aim for herd immunity. There is still no proof that the immunity gained from it, lasts more than a few months.
Imagine the fall out if a government pushes for herd immunity, knowingly sacrificing 5-10% of the population, and it turns out that country gets wave after wave of fatalities due to the herd not having a lasting immunity.
Growth rates are dependent upon testing, which is inadequate. And what little testing has been done by AZ shows a very large growth rate[1]. And the graph of growth rates by the AZ governor makes the same mistake in excluding the last 4-7 days of the graph's range. It's nonsense.
Some hospitals in NYC were overwhelmed, but that was limited to Queens and Brooklyn: the NPR piece notes that Javits Center, which was turned into a hospital in Manhattan, treated about 1100 people total, after being built to handle 1900 at a time. The three other NY field hospitals on that list, all close to NYC, treated zero patients. One of those is in the same county just north of NYC that had the initial outbreak here.
I think there's no question that COVID-19 has been a disaster here, but it's going to be heavily debated whether the lockdown saved us or just made things worse on net.
The low occupancy rate of field hospitals is evidence that either the lockdown worked, or that it was unnecessary. It excludes the case in which the lockdown was obviously necessary and just barely worked, since that's the case in which those field hospitals would themselves have been overwhelmed or nearly so, as well as the existing ICUs.
Without regard to the actual effectiveness, the fact that the field hospitals went mostly empty will fuel acrimonious debate about said effectiveness.
Yup, makes me wonder why Cuomo didn't shut down the subway system (or at least limit use based on some sort of need)? The media's given him props for leadership in his briefings, but ignored this massive sources of infections. Meanwhile, various narratives swirl about why NYC is being hit so much harder than elsewhere, like it's some sort of mystery.
I'm not sure that the data bear that out. Manhattan is the best-served borough, but the least infected. Just this week, Cuomo mentioned some surprising findings: essential workers and homeless, who make up most people on the subway, do not make up a significant number of infected showing up at hospitals, but those do who had been sheltering at home (self-reported, I imagine).
Not sure what data you're referring to. The article I saw in early March said that ridership was down over 70% in Manhattan vs only 15-20% in Queens and Brooklyn. Those numbers have now apparently fallen much further, but I've not seen a breakdown by Burrow.
New York hospitals weren't happy by any means, but their peak load was an order of magnitude less than what local leaders said they were preparing for.
"I don't want to be hurt" was an option that was swept off the table the moment we went into this disaster with a dysfunctional federal government.
Our choices since then have been "economic hardship and misery" or "economic hardship and misery with a spicy side dish of death and suffering". Covid19 has been the leading cause of death in America for a month now [1]. Some time tomorrow, it will have killed a confirmed 80,000 Americans [2] and America has consistently had 1/3rd of the world's critically-ill cases for weeks [ibid]. There is no way we are going to get out of this with less than 100,000 dead.
Amazingly, the same country that had endless investigations into the deaths of two people in Benghazi and went to war over the deaths of 3,000 Americans on September 11, 2001 -- subsequently spending $6.4 trillion in war operations [3] -- is finding 100,000 dead to be "pretty good", and the economic cost of mitigating further death to be just a little bit too expensive.
As usual, some of this is explained by political misinformation campaigns that too many people are falling for [4][5][6][7], but still, the same talking points get repeated into forums like this one, even though most Americans would prefer economic pain over a higher death toll for now [8][9][10].
I'm just gobsmacked that the disinformation is taking root so easily, because arguing that can really trivially be reduced to, "I don't think enough people are dying to justify the measures meant to prevent people from dying."
Hopefully states like California that are following more conservative, evidence-based approaches to relaxing restrictions, will relieve some of the tension.
I hate to reply so pithily to your well-researched comment, but your basic premise seems to be false here. California recognizes that economic restrictions are causing severe harm and began rolling them back today.
> California recognizes that economic restrictions are causing severe harm and began rolling them back today
But the OP wrote,
> Hopefully states like California that are following more conservative, evidence-based approaches to relaxing restrictions, will relieve some of the tension.
You are both correct: California is rolling back economic restrictions, but they are following a conservative, evidence-based approach to relaxing them. The OP's basic premise, however, is not at all false, and I sincerely hope you don't have the impression that the state is just throwing a switch and going back to "normal." It's not.
Or I should say, we're not. I don't know where you're located, but I'm in California -- the Bay Area, specifically. We don't even have official guidance on how restaurants are going to re-open yet, an the California Restaurant Association -- the business group that represents restaurants, and clearly has an economic motivation to get back to business -- has actively lobbied for the re-opening of their member businesses to happen slowly and very carefully.
I would like nothing more than to be able to start going back to my favorite restaurants and bars. But the reality is that for the last month, the daily number of new Covid-19 cases and of deaths hasn't been materially dropping in the US in the way it has in countries like the UK, Italy, and Germany, which strongly suggests that our collective behavior throughout April remained too relaxed in most states. The paradox of this pandemic is that the looser the restrictions we place on ourselves are, the more economic damage we're likely to face over the long term, not less, because we'll start cycling through repeated outbreaks, being forced to close businesses, districts, and even regions ad hoc, and running a much greater risk of overwhelming hospitals with bursts of new cases virtually all at once in stricken locales.
> the more economic damage we're likely to face over the long term,
What I don’t quite understand is how people expect the economy to “just go back to normal”... like, even if you “reopen” everything, ease all restrictions, it’s not like people are goingback to living as usual.. they’re still going to keep by themselves, because that’s an individually sensible decision... are you going to attend a conference, a wedding, a dinner party / restaurant where you’ll be near 100+ people? Of course not, you’ll be making sure you stay healthy! The economic damage will happen and persist, and governments can’t just legislate against that!
It's the same crowd that believes that the economy would have just been fine if we had treated this like we do the flu; ignoring that 2M dead Americans has a funny effect on the economy.
It saddens me that those who for some reasoning fall prey for this line of reasoning don't just hurt themselves in the process, and actively contribute to spread and worsen all problems to everyone they ever contact with.
We might be on the same page here, then. I agree it would be dumb to just immediately reopen all businesses with no thought about how to mitigate risks or delay the least safe ones. But I see a lot of people propose that relaxing restrictions doesn't matter, that it's just not an important priority relative to the virus, and that goes too far.
And that is the nature of the problem. It is far easier to throw out a random anecdote then to prove or disprove it.
I remember hearing a story of a solder that sent a single bullet into a pole mounted transformer. The oil leaked out, it over heated and exploded. Power went out to the block, maybe taking connected devices with it.
A two second act that cost less than a dollar, destroyed something that was orders of magnitude more expensive and took orders of magnitude more time to put in place.
The majority of Americans across the board support the lock down, and continue to support going slowly with relaxing restrictions. Only a small, yet well-funded minority want things relaxed ASAP.
