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Ask HN: What happens next after a successful lockdown?

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Re: Ask HN: What happens next after a successful lockdown?

#91

It's your typical pandemic response: - denial - placating measures - minor lockdowns - major lockdowns and panic (running to the store to stockpile toilet paper, for some reason) - total quarantine - life slowly returns to normal China is now on the final stage (restaurants and stores reopening, etc), with the rest of the world between 2 and 3 months behind. Most people are unable to comprehend exponential growth, so…

>It's your typical pandemic response: - denial - placating measures - minor lockdowns - major lockdowns and panic (running to the store to stockpile toilet paper, for some reason) - total quarantine - life slowly returns to normal When in the last 100 years has this happened that you're basing your 'typical pandemic response' examples on? It certainly hasn't happened in my lifetime...

Depends where you are in the world.

H1N1, SARS and Ebola are in recent memory, but they didn't reach my neck of the woods.

Re: Ask HN: What happens next after a successful lockdown?

#92
post #90

Earlier quoted context omitted.

Here's what Ralph Baric, an epidemiologist from the University of North Carolina Chapel Hill, had this to say on episode 591 of This Week in Virology[1] a couple of days ago: Ralph Baric: "I saw some very interesting data from Stan Perlman the other day, who has been looking at serum neutralization titers of MERS patients from the Middle East kingdom of Saudi Arabia area and it's quite intersting that people peak fai…

Could you clarify this for laymen?

There's precedent, it makes sense with our knowledge, we have seen people who are apparently reinfected, we can likely soon find evidence for or against the idea

Re: Ask HN: What happens next after a successful lockdown?

#93
post #90

Earlier quoted context omitted.

Here's what Ralph Baric, an epidemiologist from the University of North Carolina Chapel Hill, had this to say on episode 591 of This Week in Virology[1] a couple of days ago: Ralph Baric: "I saw some very interesting data from Stan Perlman the other day, who has been looking at serum neutralization titers of MERS patients from the Middle East kingdom of Saudi Arabia area and it's quite intersting that people peak fai…

Could you clarify this for laymen?

"The Immune response for MERS tapers off over a year; but we don't know what the immune response is of SARS2, it looks very different, it might be very short lived, we need more evidence"

Re: Ask HN: What happens next after a successful lockdown?

#94
post #41

I’m surprised that no one here is mentioning the example of South Korea. [1] They are not in total lockdown, but they are doing extensive testing and contact tracing, and substantial isolation of anyone who might be contagious. Once we get testing infrastructure ramped up, this is not an unreasonable plan in the United States. [1]: https://www.bbc.com/news/world-asia-51836898

Because it's too late. The time for that in the US was at least two weeks ago. This is why the US response to this has been driving so many of us crazy. The later you respond the fewer options you have.

One other consideration: The population of the United States is six times larger than South Korea's. Keep this in mind when comparing the total number of cases in each country.

Re: Ask HN: What happens next after a successful lockdown?

#95
post #64

Earlier quoted context omitted.

Was this the article you were reading with the 3600 days analysis? I just read it. Not sure what to make of it yet. https://medium.com/@joschabach/flattening-the-curve-is-a-dea...

The "Containment works" part seems questionable. In particular, South Korea almost certainly wasn't "tracking its first 30 cases very well, until patient 31 infected over 1000 others on a church congregation". Patient 31 didn't have any known source of exposure - she hadn't travelled abroad or had any contact with known cases, didn't even meet South Korea's criteria for testing, the most likely place she got Covid-19…

It is my understanding that the church is sort of a cult, and it's followers hide their membership.

This illustrates the challenge with tracing approaches: if people are not open, or not sufficiently aware of the consequences of their actions, it's very easy to miss infections.

Re: Ask HN: What happens next after a successful lockdown?

#96
post #18

Earlier quoted context omitted.

I saw a statistical analysis of the flatten the curve idea but assuming we couldn't ramp up the number of intensive care beds, it took 3600 days to fit everyone in under the "available health care" line. It's still a good strategy for right now because it gives us some extra time to ramp testing and healthcare up.

The more optimistic way of looking at this is: the 'flatten the curve' scenario has to get so close to R0 This is difficult, not impossible. We'll see what actually happens.

Looking at the people happily strolling around and gathering in public cafes as if nothing was going on, I severely doubt it. (large city in Germany btw)

Re: Ask HN: What happens next after a successful lockdown?

#97
post #90

Earlier quoted context omitted.

Here's what Ralph Baric, an epidemiologist from the University of North Carolina Chapel Hill, had this to say on episode 591 of This Week in Virology[1] a couple of days ago: Ralph Baric: "I saw some very interesting data from Stan Perlman the other day, who has been looking at serum neutralization titers of MERS patients from the Middle East kingdom of Saudi Arabia area and it's quite intersting that people peak fai…

Could you clarify this for laymen?

I don't have medical training myself, so my own understanding is only that of an interested layman who's been following this closely. So please take what I say with a grain of salt, but here's my understanding of what Dr Baric said:

In the first paragraph he speaks of evidence that immunity waned over time in the case of a closely related disease called MERS.

In the second paragraph he talks about the mystery of how all human coronaviruses (including some of the viruses that cause the "common cold", the virus that causes MERS, and SARS-Cov-2: the virus that causes COVID-19, aka "The Coronavirus") keep themselves alive in the human population. He didn't say so explicitly, but the implication is that we should expect these coronaviruses to die out as humans get sick, recover, and acquire immunity to them.. but that's not what happens. People get sick with these same viruses again and again and again.

In the case of the flu (which is not a coronavirus), the way it keeps reinfecting people is that it mutates a lot in ways that will evade acquired immunity, so any immunity a person had from having had and recovered from the flu will not keep them from getting sick with another, mutated variation of the flu.

But that doesn't happen with human coronaviruses. People keep getting infected with the same strain. So the educated guess (the hypothesis) is that being infected and recovering from the coronavirus does grant some immunity, but that immunity quickly fades and then people get reinfected with the same strain because they no longer have that immunity (or have too little of it to keep from getting infected).

Then he mentions reports from China of people getting infected with the coronavirus, recovering, and then getting reinfected (which should support the above hypothesis, but we can't be sure because China has not been actually monitoring the levels of antibodies in infected and recovered people in their population).

In the final paragraph, Baric says he expects the US health care system to closely track the level of antibodies in infected and recovered people over time, which should give us some insight in to whether this hypothetical reduction in immune response really does happen.

Re: Ask HN: What happens next after a successful lockdown?

#98
post #66

One word... Summer.. once the summer starts and we see 30c or above , i think the spread will be limited and the quarantine might end. But, worrying part is what comes next, without a Vaccine, coming Winter might be lethal, and we may end up with same cycle.. https://www.scmp.com/news/china/science/article/3074131/coro...

It's summer in Australia and South Africa. They're still seeing spread. I wouldn't count on that.

Is there any information on how many of the ~377 Australian cases originated outside versus inside their borders? I can't find much on that figure.

South Africa only has 62 cases and New Zealand only has 8 cases. Not much there yet.

Re: Ask HN: What happens next after a successful lockdown?

#99
post #95
post #64

Earlier quoted context omitted.

The "Containment works" part seems questionable. In particular, South Korea almost certainly wasn't "tracking its first 30 cases very well, until patient 31 infected over 1000 others on a church congregation". Patient 31 didn't have any known source of exposure - she hadn't travelled abroad or had any contact with known cases, didn't even meet South Korea's criteria for testing, the most likely place she got Covid-19…

It is my understanding that the church is sort of a cult, and it's followers hide their membership. This illustrates the challenge with tracing approaches: if people are not open, or not sufficiently aware of the consequences of their actions, it's very easy to miss infections.

Today and yesterday I have seen countless people who just dont care. Viral pandemic currently causing society to shut down?

Let's go meet in a cafe!

And that's not even the, sorry, assholes at the supermarkets. It was insane today.

Re: Ask HN: What happens next after a successful lockdown?

#100

Earlier quoted context omitted.

You mean like aciclovir for herpes, or the various antivirals for HIV, or the monoclonal antibodies for ebola?

They are suppressors of symptoms/disease management helpers not cures. Ebola patients either die or their immune system fights off the disease.

That's patently false. Antivirals slow the reproduction rate of the virus giving your immune system the upper hand; monoclonal antibodies do exactly what your immune system would do, they bind to the virus either neutralizing it or allowing macrophages to detect and destroy it.
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