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California’s Roadmap to Modify the Stay-at-Home Order [pdf]

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Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#111

Post by marktangotango »

mchusma wrote: post #67

A real plan would look like this https://imgur.com/spemOeG specifying the levels of restrictions and the metrics we will use to track the metrics. This allows people to understand what to expect the best possible. We already have huge uncertainty, we don't need to add uncertainty of government response on top of uncertainty of the virus. I think there is huge room to debate the numbers and what goes in what level, bu…

> Is he going for suppression? Is he going for mitigation?

This is the factor that has been missing from all the reporting on this crises. The goal of suppressing the virus to zero and merely seeking mitigate the virus surge effect on available ICU beds leads to drastic differences in all metrics most notably “peak deaths”. If the goal is mitigation with rolling shutdowns, there will be many many more deaths. Virus suppression require several months of shutdown. This is the most basic result of the “models”.

None of the major outlets have reported on this at all.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#112

Post by yodsanklai »

I would cynically summarize this as: lockdown is economically unsustainable. We need to go back to work. Let's hope we can control the epidemics this time better than before the lockdown. We may have new tools this time (contact tracing, masks, test). But we're not really sure they'll work.

It's the exact same situation in France where we're planning to go out of lockdown in 4 weeks. It seems unclear that we'll have the needed tools by then. It's not even clear that they'll work but there are no other options.

At least the California roadmap isn't pretending they have the answers to the question they raised...

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#113

Post by majormajor »

mikekij wrote: post #30

This entire plan is based on models that do not align with what we are seeing. The graph on slide two[1] of the official CA govt plan shows hospitalizations With Intervention rising exponentially, exceeding our hospital capacity in early June. The actual new infection data shows that the rate of new infections has been decreasing since at least 4/4 [2], meaning that the graph of active hospitalizations should be a be…

Can you trust that data to be perfectly comparable? Testing capacity ramped up at a different rate than cases. Testing guidance has been spotty too. The days right after increases in testing access could be very noisy.

I would look to the deaths curve much before the new cases curve, even though it's less responsive to changes. I assume fewer deaths have slipped through the cracks (though I'm sure some have).

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#114

Post by clairity »

phkahler wrote: post #97
mchusma wrote: post #67

A real plan would look like this https://imgur.com/spemOeG specifying the levels of restrictions and the metrics we will use to track the metrics. This allows people to understand what to expect the best possible. We already have huge uncertainty, we don't need to add uncertainty of government response on top of uncertainty of the virus. I think there is huge room to debate the numbers and what goes in what level, bu…

>> I like many others are deeply upset by leadership from both parties, at all levels of government. I'm sitting at home in Michigan where the governor has closed almost all businesses. Politicians bicker over weather governors or the president have the authority to reopen things. And yet there is no plan as far as I can see. No goals, no criteria to trigger next steps, nothing. Meanwhile the press just snipes at peo…

it's tough to have productive coordination when the president knows so little about civics and government. it's best to ignore the president in this case, especially since he constitutionally has very little say in a pandemic response.

instead, focus on putting political pressure on your state and local politicians to come up with a concrete plan and timeline, as they're the ones who do hold power in this case.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#115

Post by gdulli »

sergiotapia wrote: post #106

I don't understand why at risk people don't just stay at home. Why lock everybody else up? Enough is enough, kids need to go back to school and people need to go back to work. This document seems hand-wavy and doesn't answer anything.

First, because they live with people who aren't at risk and if those people go about their lives it defeats the purpose.

Second, if everyone not explicitly at high risk went about their normal business, some percentage of them would still need medical attention and the hospitals would run out of beds, leaving some to die.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#116

Post by kurthr »

SpicyLemonZest wrote: post #95
kurthr wrote: post #4

I’d like to see something that’s clear and doesn’t risk so much on rapid accurate testing and tracking of... everyone with significant delayed feedback. Something that could be done in rural areas or even developing countries. A reliable next step in the Hammer and the Dance. I found this: http://pandemicbreak.org/

I don't mean this to be a gotcha, but society has a lot of hidden complexity. Rigid prescriptive proposals like this are unlikely to be good ideas, which is why governments haven't been presenting them. In this particular case, the plan is great for personal life but is clearly infeasible economically. You can't just toggle a factory on and off every 2 weeks; it depends on supply chains extending weeks into the past…

Currently, those businesses can't plan on anything a month away. There could be demand or not, supplies or not, workers or not... nobody knows. Demand is crushed and never returns...

Now consider the alternative. You know that you will be open in 2 weeks, you know when you need get parts there, and you know when demand will show up. You can still use some amount of "essential" work at the corners. The point of the two phases is to make sure that things don't blow back up again and to make it obvious to everyone that it's fair.

Then, demand is shifted rather than destroyed and the economy can function at slightly reduced capacity while still keeping the viral contagion controlled (not some crazy let's hope there's herd immunity and let everyone get it, or we'll keep the ICUs full for 18 months and hope the immunity lasts that long).

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#117

Post by citilife »

mikekij wrote: post #30

This entire plan is based on models that do not align with what we are seeing. The graph on slide two[1] of the official CA govt plan shows hospitalizations With Intervention rising exponentially, exceeding our hospital capacity in early June. The actual new infection data shows that the rate of new infections has been decreasing since at least 4/4 [2], meaning that the graph of active hospitalizations should be a be…

Something weird happened in California, where 20% of their tests were coming back positive, then all the sudden 04/04/2020 they started seeing https://raw.githubusercontent.com/lettergram/covid19-analysi...

They also barely tested at all prior to 04/04/2020:

https://raw.githubusercontent.com/lettergram/covid19-analysi...

In generally though, the rate of positive tests is increasing nation wide:

https://raw.githubusercontent.com/lettergram/covid19-analysi...

Implying we are still on a solid growth curve, as our testing capacity has maintained relatively constant levels:

https://raw.githubusercontent.com/lettergram/covid19-analysi...

I can't speak to the hospitalization levels, but I suspect people are avoiding the hospital. My roommate decided not to get tested and stay home, even though he was having difficulty breathing. He seems past it after a couple weeks.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#118

Post by impendia »

clairity wrote: post #108
hilbertseries wrote: post #61

Earlier quoted context omitted.

LA county now requires anyone entering an essential business to wear a mask.

this is probably a little overly cautious relative to the actual reduction in risk (you'd have to be especially unlucky to get infected just from regular breathing in a grocery store), but not terribly unreasonable, particularly for those with co-morbidities. but i routinely see people with masks and gloves on while walking outside. not shopping, or going to shop, just walking. it's so odd, and frankly, wasteful.

> frankly, wasteful.

I think I disagree.

It seems that face masks are quite effective in reducing the spread of illness. For example, look at the numbers in South Korea, Japan, etc. (where mask-wearing is common) compared to ours. Masks don't need to do 100% of the job -- rather, we would hope that in combination with moderate social distancing, better hygiene, improved testing, etc. we could reduce the rate of transmission. If each infected person spreads the illness to an average of only 0.9 others, then it won't do much more damage.

Now, from an economic angle, the US government just passed a $2 trillion stimulus package, which works out to about $6,000 per American. There are calls to spend much more money. Suppose we spend 5% of this on face masks, so $300 per American.

Currently, face masks can be bought at $20 for a box of 50 on Amazon. That gets 750 face masks to every American, at a cost that is cheap relative to the other costs of Covid-19.

And this is ignoring economies of scale. If the government decided to distribute free face masks in every school, every restaurant, in every theater, etc., then it could produce them at much cheaper than 40 cents each.

All in all, it seems like a potentially good investment.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#119

Post by SpicyLemonZest »

marktangotango wrote: post #111
mchusma wrote: post #67

A real plan would look like this https://imgur.com/spemOeG specifying the levels of restrictions and the metrics we will use to track the metrics. This allows people to understand what to expect the best possible. We already have huge uncertainty, we don't need to add uncertainty of government response on top of uncertainty of the virus. I think there is huge room to debate the numbers and what goes in what level, bu…

> Is he going for suppression? Is he going for mitigation? This is the factor that has been missing from all the reporting on this crises. The goal of suppressing the virus to zero and merely seeking mitigate the virus surge effect on available ICU beds leads to drastic differences in all metrics most notably “peak deaths”. If the goal is mitigation with rolling shutdowns, there will be many many more deaths. Virus s…

The idea of suppressing the virus to zero just doesn't really exist outside of certain circles. Every government I'm aware of has acknowledged that there will be many more deaths, and all of my friends and family expect that.

Re: California’s Roadmap to Modify the Stay-at-Home Order [pdf]

#120

Post by mdorazio »

wbl wrote: post #49
mdorazio wrote: post #13

Earlier quoted context omitted.

Ok, thanks for the additional context. Was there any mention of actual targets for these things? Ex. "I'd like to see a 10% reduction of hospitalizations and at least 1M tests."

Why would there be? If something goes really wrong in one of those pushing it off a goal is going to be a problem.

Because without those things it's not a real plan. Anyone can say "we'll change policies when things get better". Defining what "better" means is the actual challenge and exactly what people as a whole are looking for.
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