California’s Roadmap to Modify the Stay-at-Home Order [pdf] • Hacker News Board

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

#361

Post by wbronitsky » Wed, Apr 15, 2020, 12:59 PM UTC

mchusma wrote: post #190

_vertigo wrote: post #142

Earlier quoted context omitted.

I don't really think you fully appreciate what how your "real plan" or your accompanying nitpicks would be received by the average citizen. The biggest pitfall, as has already been pointed out by another reply, is that it creates concrete expectations that the government will be held accountable for. Secondly, most of your nitpicks are great if you want to nerd out over the details of the epidemic, but most people ar…

Thank you for your reply. I don't understand the objection that this is locking government in. Every level of government keeps setting dates then changing them, so I don't see how changing a criteria for a level is worse.

That’s because you don’t understand what you are talking about. You have waded into a debate where people are informed and you are not, yet when faced with an informed opinion you dismiss it as it doesn’t make sense. This is type of argumentation is a disease, ruining our ability to learn things and expose ourselves to other opinions on HN

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

#362

Post by impendia » Wed, Apr 15, 2020, 1:10 PM UTC

clairity wrote: post #167

impendia wrote: post #118

Earlier quoted context omitted.

> 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 trans…

99% of the reduction in transmission comes from physical distancing alone while inside of closed spaces with strangers . hygiene is likely negligible outside of a very few high interaction zones inside those enclosed spaces. testing only improves targeting who to distance (isolate). it's a virus that rides on tiny masses of water to hopefully jump into the nasopharyngeal cavity of the next host. if it doesn't make it…

> 99% of the reduction in transmission comes from physical distancing alone while inside of closed spaces with strangers.

This is an extremely strong statement. Although it might be plausibly true, my impression is that the transmission of the disease isn't well enough understood to make such assertions with confidence.

Can you cite a reference for your claim?

I think it is agreed that physical distancing alone while inside of closed spaces with strangers is an extremely good idea. Wearing masks is, potentially, also an extremely good idea.

Shouldn't we adopt any and all measures that have the potential (not certainty; potential is enough) to substantially cut down on Covid-19 transmission, and whose economic and other costs are comparatively modest? Even if we later determine that only one of these measures was really necessary, I doubt that we'll regret our efforts.

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

#363

Post by clsec » Wed, Apr 15, 2020, 1:12 PM UTC

jmckib wrote: post #263

ABeeSea wrote: post #5

Earlier quoted context omitted.

He said during the press conference that exact dates might be available in two-four weeks. He wants to see a further reduction in hospitalizations, an increase in testing, and a supply chain for PPE before committing to reopening dates.

Is there a video of the press conference somewhere? It's hard to make sense of these slides without any context.

here you go: https://www.youtube.com/watch?v=06YK2SExixo

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

#364

Post by marcinzm » Wed, Apr 15, 2020, 1:20 PM UTC

mr_spothawk wrote: post #305

marcinzm wrote: post #235

Earlier quoted context omitted.

The death rate is 0.5% IF there's really good medical treatment. If there isn't then not only does the death rate from the covid go up but so do death rates for every other condition requiring medical treatment. And not only during the pandemic but for a some time afterwards as the health system recovers. That's not counting those who survive but have some form of permanent damage. The way to avoid that is to at leas…

> The death rate is 0.5% You can't know that without testing the whole population, or at least getting some controls.

They did random anti-body testing in a small town if I remember correctly and found it to be 0.5% or so.

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

#365

Post by clsec » Wed, Apr 15, 2020, 1:48 PM UTC

mdorazio wrote: post #120

wbl wrote: post #49

Earlier quoted context omitted.

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.

Newsom said he was giving this information to the public in the interest of disclosure. He wants the public to know what they're doing behind the scenes. He said it was just what they've been talking about, not a plan. He stated that any of this could change at a moments notice and to keep on doing what CA residents are doing because we do seem to be plateauing a bit.

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

#366

Post by squillesque » Wed, Apr 15, 2020, 1:48 PM UTC

simonh wrote: post #353

jml7c5 wrote: post #152

Earlier quoted context omitted.

>Something weird happened in California, where 20% of their tests were coming back positive, then all the sudden 04/04/2020 they started seeing This is not surprising. When tests were scarce, tests would be rationed to those most suspected of infection.

The cases reported per country, or state are only a narrow window into what is actually happening. The most advanced medical testing company in the world, Roche, is Swiss-German so Germany's testing capability relative to most countries is off the charts. Combined with a highly distributed, yet also highly co-ordinated health care system they have been ahead of the curve in testing on every conceivable metric. As a r…

But hospital admission cases depends on perceived hospital resources too... if people think going to the hospital is worse than staying at home, or impossible, that will distort conclusions also.

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

#367

Post by hedora » Wed, Apr 15, 2020, 1:53 PM UTC

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…

(5) In 1918, due to a combination of shelter in place, and seasonality the virus had time to mutate into something much deadlier before herd immunity was established. What is the plan for establishing herd immunity before the next strain of COVID arrives (~this fall)?

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

#368

Post by squillesque » Wed, Apr 15, 2020, 2:01 PM UTC

archgoon wrote: post #51

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…

Why should infections follow a bell curve? Shouldn't it be the derivative of a the logistic curve, which should be approximately exponential on both ends. I don't see how a quadratic should show up in the exponent; either mathematically or epidemiologically.

You can approximate one with the other; it used to be common when normals were harder to work with early computers.

Eg, https://www.johndcook.com/blog/2010/05/18/normal-approximati...

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

#369

Post by bhickey » Wed, Apr 15, 2020, 2:02 PM UTC

adrianmonk wrote: post #126

bhickey wrote: post #54

Earlier quoted context omitted.

> Another view is that opening the economy should involve testing people who are NOT symptomatic. Testing people with symptoms is a waste of tests. When tests are in short supply assume everyone with symptoms is positive, isolate them and test their contacts who don't have symptoms. As of last week, Boston Medical Center had a 44% positive rate on the tests they were running on symptomatic people. They could find mor…

I'm very tempted to argue that in any successful plan, a pretty small minority of the population would be symptomatic at any given time. And the above article has me convinced we should be testing asymptomatic people on a very wide scale in order to get the economy going again. (Enough to test most of the population regularly, like every two weeks.) Together, those two things tell me we should have such a large testi…

> we should have such a large testing capacity that testing symptomatic people isn't a stretch.

We should, but we don't. Group testing dramatically expands the number of people we can test. However group testing collapses at high prevalence. Since we expect people with fever and cough to be more likely COVID+ than the general population prevalence when we can only run a limited number of cases we'll inevitably miss more positives by testing people with symptoms.

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

#370

Post by xienze » Wed, Apr 15, 2020, 2:09 PM UTC

Loughla wrote: post #355

altcognito wrote: post #352

Earlier quoted context omitted.

I think there was genuine concern that the quarantine as implemented would not be enough. You can see lots of stories locally wherever you are about how people aren't obeying the order. Italy was still in a lot of trouble despite having had some quarantine measures in place. Hindsight shows the quarantine was effective enough to get numbers down. The US, despite reacting too late, did lockdown fully relatively quickl…

>The US missed the worst of hospitals being overrun and it running away in multiple cities. I want to add ", so far" to the end of that sentence. I do not hold hope that this will be true as we fight among ourselves to reopen various portions of the country/economy.

> I do not hold hope that this will be true as we fight among ourselves to reopen various portions of the country/economy.

But things won’t be the same after reopening as they were before. People will be wearing masks (I see a lot of that already), keeping distance, etc. Couple that with common sense restrictions like “keep the elderly and sick at home”, “no big public events”, “no sporting events”, and “lots of restaurants have gone out of business”, it’s clear the opportunity for infection spread will be lower.