BF2S Forums Pandemic thread

Larssen wrote:

Jay there's 3 scenario's:

1. Let covid-19 run its course. Hospitals in your entire country will quickly be overrun by hundreds of thousands of deathly ill people. No one has immunity, so it is likely the majority of the US population would contract the virus. With a growth factor of 10% daily the entire population could be infected in a matter of months. Your healthcare & insurance industry would collapse, not to mention literally millions of dead people in a matter of MONTHS. As a surprising amount of young people need help, expect those 60+ or even 50+ to not get the aid they need. This could also cause superinfections and quick mutations due to the rapid spread.

2. Lock everything down completely, to the point that nobody is allowed to leave their homes. Considering there's no vaccine, this would be a wait-and-pray strategy hoping covid-19 will be completely eliminated in due time. This could at current numbers take over a year. The societal and economic consequences would be disastrous. Great depression levels of disastrous. Also, when quarantine is lifted covid-19 will strike again because immunity has not been built in the population.

3. Sustained control of the virus. Strengthening and loosening containment measures throughout the coming period to limit the amount of people that will end up in the hospital simultaneously. This will build herd immunity while allowing life as usual to continue in some way. The majority of the population will probably still contract corona, but all those in need will be helped. A deep recession is inevitable, but industries could survive and deaths will be limited.

Those are the only 3 outcomes virologists, ICU surgeons and other medical experts have predicted for us. Pick your poison. There is no good answer. You still don't grasp the gravity of what's happening - it's the first real pandemic in 100 years. I do sympathise, as the USA is the least prepared country in the West to deal with this situation. Your lack of social securities and how that will affect infection rates & stability is even a point of discussion in Europe.

Jay wrote:

Larssen wrote:

Jay there's 3 scenario's:

1. Let covid-19 run its course. Hospitals in your entire country will quickly be overrun by hundreds of thousands of deathly ill people. No one has immunity, so it is likely the majority of the US population would contract the virus. With a growth factor of 10% daily the entire population could be infected in a matter of months. Your healthcare & insurance industry would collapse, not to mention literally millions of dead people in a matter of MONTHS. As a surprising amount of young people need help, expect those 60+ or even 50+ to not get the aid they need. This could also cause superinfections and quick mutations due to the rapid spread.

2. Lock everything down completely, to the point that nobody is allowed to leave their homes. Considering there's no vaccine, this would be a wait-and-pray strategy hoping covid-19 will be completely eliminated in due time. This could at current numbers take over a year. The societal and economic consequences would be disastrous. Great depression levels of disastrous. Also, when quarantine is lifted covid-19 will strike again because immunity has not been built in the population.

3. Sustained control of the virus. Strengthening and loosening containment measures throughout the coming period to limit the amount of people that will end up in the hospital simultaneously. This will build herd immunity while allowing life as usual to continue in some way. The majority of the population will probably still contract corona, but all those in need will be helped. A deep recession is inevitable, but industries could survive and deaths will be limited.

Those are the only 3 outcomes virologists, ICU surgeons and other medical experts have predicted for us. Pick your poison. There is no good answer. You still don't grasp the gravity of what's happening - it's the first real pandemic in 100 years. I do sympathise, as the USA is the least prepared country in the West to deal with this situation. Your lack of social securities and how that will affect infection rates & stability is even a point of discussion in Europe.

Go fuck yourself.

Last edited by Larssen (2020-03-16 14:51:37)

The global impact of COVID-19 has been profound, and the public health threat it represents is the most serious seen in a respiratory virus since the 1918 H1N1 influenza pandemic.

Two fundamental strategies are possible: (a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely. Each policy has major challenges. We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.

We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures, though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism. The major challenge of suppression is that this type of intensive intervention package – or something equivalently effective at reducing transmission – will need to be maintained until a vaccine becomes available (potentially 18 months or more) – given that we predict that transmission will quickly rebound if interventions are relaxed. We show that intermittent social distancing – triggered by trends in disease surveillance – may allow interventions to be relaxed temporarily in relative short time windows, but measures will need to be reintroduced if or when case numbers rebound. Last, while experience in China and now South Korea show that suppression is possible in the short term, it remains to be seen whether it is possible long-term, and whether the social and economic costs of the interventions adopted thus far can be reduced.

• the UK mitigation/peak flattening strategy was based on flawed assumptions, schools and unis must shut down immediately and maximum household quarantine be applied to stop thousands dying daily and the NHS being swamped
• the US strategy, such as it is, is equally flawed
• China’s approach is also problematic, as in the absence of a vaccine, any relaxation of universal quarantine is likely to lead to an epidemic resurgence
• the only viable way forward is  permanent, or repeatedly restarted, universal household isolation until a vaccine is ready - probably one and a half years
• that is: no physical attendance of school, uni or going out for one and a half years
• the only point of hope is that relatively successful anti-Covid campaigns in Japan, Singapore and South Korea point to a better, quicker way of suppressing outbreaks

Last edited by uziq (2020-03-16 16:32:11)

In the (unlikely) absence of any control measures or spontaneous changes in individual behaviour, we would expect a peak in mortality (daily deaths) to occur after approximately 3 months (Figure 1A). In such scenarios, given an estimated R0 of 2.4, we predict 81% of the GB and US populations would be infected over the course of the epidemic. Epidemic timings are approximate given the limitations of surveillance data in both countries: The epidemic is predicted to be broader in the US than in GB and to peak slightly later. This is due to the larger geographic scale of the US, resulting in more distinct localised epidemics across states (Figure 1B) than seen across GB. The higher peak in mortality in GB is due to the smaller size of the country and its older population compared with the US. In total, in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality.

For an uncontrolled epidemic, we predict critical care bed capacity would be exceeded as early as the second week in April, with an eventual peak in ICU or critical care bed demand that is over 30 times greater than the maximum supply in both countries (Figure 2).

Last edited by uziq (2020-03-16 17:12:36)

Perhaps our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

In the UK, this conclusion has only been reached in the last few days, with the refinement of estimates of likely ICU demand due to COVID-19 based on experience in Italy and the UK (previous planning estimates assumed half the demand now estimated) and with the NHS providing increasing certainty around the limits of hospital surge capacity.

We therefore conclude that epidemic suppression is the only viable strategy at the current time. The social and economic effects of the measures which are needed to achieve this policy goal will be profound. Many countries have adopted such measures already, but even those countries at an earlier stage of their epidemic (such as the UK) will need to do so imminently.

Last edited by uziq (2020-03-16 17:37:05)

Jay wrote:

https://slate.com/human-interest/2020/03/restaurant-fired-staff-coronavirus-new-york.html

Last edited by Dilbert_X (2020-03-16 17:48:30)

Dilbert_X wrote:

China and Korea seem to have this thing on hold, we should do what they're doing.

Simple enough?

uziq wrote:

Dilbert_X wrote:

China and Korea seem to have this thing on hold, we should do what they're doing.

Simple enough?

the idea is as soon as they switch out of total suppression and heavy interruption of everyday life, there's a high chance things will rapidly return to epidemic-levels.

i know your wet dream is the world being totally segregated and un-integrated, forever, but that's not going to happen.

uziq's experts wrote:

the only viable way forward is  permanent, or repeatedly restarted, universal household isolation until a vaccine is ready - probably one and a half years
that is: no physical attendance of school, uni or going out for one and a half years

uziq wrote:

Jay wrote:

uziq wrote:

why is it ridiculous?


all the data is there in the paper.

Because shutting down the world for 18 months while waiting for a vaccine is completely irrational. Kids need to go to school. People need to go to work. The world needs to go on. People will die. People die every day anyway.

make sure to volunteer your parents and in-laws for the 2.2 million americans who have gotta go.