"To think that we're in New York City and this is happening," he added. "It's like a third-world country type of scenario. It's mind-blowing."Historically, when sexually transmitted disease outbreaks occurred in the US, social workers would ask for the names of everyone you had slept with if you were infected and they would contact them and screen them and treat them. This was effective in stopping outbreaks.
We largely abandoned this approach after AIDS became a thing. In the US, AIDS was mostly a disease of IV drug users and gay men, both of whom were highly stigmatized populations. They understandably did not wish to give up the names of people they had slept with (or shared needles with).
Although I think we got a lot of human rights gains out of the battle to protect those populations, the downside is that we largely abandoned a proven method for putting a stop to disease outbreaks. Instead, we now default to trying to find drugs and vaccines rather than trying to stop the spread via "social" means (for lack of a better word).
There is a book called The Hot Zone that similarly describes non-medical/social interventions that helped stop the spread of Ebola. Among other things, tribal elders in Africa blockaded the roads so outsiders couldn't come in, they told their people "Don't go to the white man's hospital" because you go with a broken leg and die of Ebola and they began quarantining the sick.
You were forbidden from leaving your hut. They would leave food on your front doorstep for you to provide for you. If it sat there for three days in a row untouched, they burned the hut down without going in to check if you were still alive.
We are currently focusing a lot on ventilators. I've seen numerous articles on ventilators on HN and there are numerous projects trying to develop open source ventilators. Meanwhile, we are apparently largely overlooking noninvasive lung clearance techniques that can help with less extreme cases and may help prevent them from becoming such.
In human history, epidemics tend to mostly get stopped with non-medical interventions. Yes, I know, there are states under lock down. I'm in one of them.
But I feel I am seeing inadequate emphasis on prevention, changes in lifestyle, promotion of remote work as a solution, non-medical home care options so fewer people end up at the overwhelmed hospitals where care is getting rationed etc.
I have been saying for some days now that high use of ventilators will promote a rash of antibiotic resistant secondary infections. There has been at least one article posted to HN that suggested that antibiotic resistant infections may be a factor in the high death rate in Italy.
I think we can do better. I think that's not going to happen as long as we continue to worship medical intervention as the answer here.
I think lifestyle and procedural changes are needed. An ounce of prevention is worth a pound of cure and prevention doesn't require you to see a medical professional or get prescribed anything, yet everyone acts like either that's not going to be effective or it is too objectionable to embrace or making suggestions of that sort amounts to practicing medicine without a license.
-----
Previous comment about the history of AIDS in the US: https://news.ycombinator.com/item?id=22658583
PDF version of The Hot Zone: http://projectavalon.net/THE_HOT_ZONE_Richard_Preston.pdf
Previous comments by me about about air clearance techniques and ventilators: https://news.ycombinator.com/item?id=22651884
To the people inclined to harass me and threaten to sic the mods on me for commenting here, the mods appear to be well aware of my comments and have already asked someone to please cease and desist harassing me: https://news.ycombinator.com/item?id=22660362