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A Third Solution

paulbuchheit.blogspot.com

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Re: A Third Solution

#11

Post by jawns »

> If we were able to identify and quarantine everyone who is contagious, including those who are asymptomatic, then we could let everyone else out of lockdown and resume ordinary social and economic activity.

> Even with imperfect screening, if we are able to prevent 90% of disease transmission, then the virus’s reproductive number, or R0, will drop below one and the pandemic will quickly fade. There is no risk of reintroduction from the outside because any new outbreaks will quickly be caught and contained. If used consistently, there will be no second wave, ever.

I'm not sure this "test and release" strategy works unless absolutely everybody gets tested simultaneously.

Even if testing of the total population can be completed in a week (a highly ambitious timeframe), there's still time for people released on Day 1 to be reinfected by people who don't get tested until Day 6.

Then you have to go through who knows how many follow-up rounds of testing absolutely everybody not in quarantine to identify those people. When responding to new outbreaks involves re-testing large populations of people, you're going to run into many problems. Notification, compliance, testing fatigue, etc.

Sounds like a logistical nightmare.

Re: A Third Solution

#12

Post by johnnyo »

marcell wrote: post #6

> First of all, it’s not “just the flu”. It is something much more dangerous. Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead I think this is mischaracterizing it. People have to die eventually. One year of existence has a mortality rate of 1%. For a 75-84 year old individual it is nearly 5%. Above 85 it's 14%. [1] The coronavirus infection fat…

The things that generally kill Americans (heart disease, cancer, car crashes, diabetes, etc) aren’t contagious, so this is a bad analogy.

Re: A Third Solution

#13

Post by caymanjim »

This isn't a unique idea. This is the mainstream view. Everyone knows we need more testing and that testing is the only way to effectively ease distancing rules. That was a pretty extensive writeup to say what we've been hearing from all rational information outlets for a month.

Re: A Third Solution

#14

Post by dang »

uhnuhnuhn wrote: post #5

Can we stop hyping blog posts by tech people writing about epidemiology and medicine? I'm shocked how much baseless speculation and misinformation is being shared on HN.

HN is an internet watercooler. It exists for curious conversation. That inevitably includes speculation—that's what people do when they converse. The question is whether it's curious (thoughtful and fresh) or uncurious (reflexive and predictable).

People being wrong is also inevitable. We don't have a truth meter, and there's a ton of uncertainty on topics like this one anyhow. I don't think it would work to try to restrict discussion so that only authoritative opinions are allowed. This community would not tolerate that sort of restriction being put on it, and it would only convert to an argument-by-proxy about who should count as authoritative. The solution, if there is one, is to converse thoughtfully and respond to one another with accurate information where possible.

Re: A Third Solution

#15

Post by 762236 »

One way to achieve ubiquitous screening is for people to perform regular VO2max tests (loosely speaking; you can do submaximal exercises for this). You quickly figure out if you have a stress on your immune system (by watching various metrics), and there are sports-science papers showing this (because they use it to avoid overtraining, which also appears as a stress on the immune system). This is of course not easy to achieve with our current culture. It used to be that physical achievement was valued. Only a small fraction of society pushes against their VO2max in a regular way that can be measured and tracked to detect the immune-system stress. If people were to pursue this approach, they'd become a lot healthier in general.

Re: A Third Solution

#16

Post by pb »

jawns wrote: post #11

> If we were able to identify and quarantine everyone who is contagious, including those who are asymptomatic, then we could let everyone else out of lockdown and resume ordinary social and economic activity. > Even with imperfect screening, if we are able to prevent 90% of disease transmission, then the virus’s reproductive number, or R0, will drop below one and the pandemic will quickly fade. There is no risk of re…

It's daily screening for exactly that reason. Is there something I should change to make that more clear?

Re: A Third Solution

#17

Post by JoeAltmaier »

marcell wrote: post #6

> First of all, it’s not “just the flu”. It is something much more dangerous. Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead I think this is mischaracterizing it. People have to die eventually. One year of existence has a mortality rate of 1%. For a 75-84 year old individual it is nearly 5%. Above 85 it's 14%. [1] The coronavirus infection fat…

That's a terrible analysis, for reasons well-covered all over HN and elsewhere.

This is a whole different thing from 'another flu'. We have to address it head-on. Throwing people (a million people?) under the bus is not going to fly, not politically and not morally.

Re: A Third Solution

#19

Post by roywiggins »

triyambakam wrote: post #3

The article begins by stating that this is not like the flu, yet we know people die from complications or directly from the flu every year. And further, we're seeing more and more evidence of huge numbers of the population with antibodies, i.e. already infected and immune. We also have seen the damage that using ventilators have had due to misunderstanding how this virus starves the body of oxygen (through the blood,…

It's not the flu because the infection fatality rate is almost certainly a lot higher, we have no vaccine, and no reliable treatments. Seasonal flu has (semi-reliable) vaccines and antivirals and is almost definitely significantly less deadly.

Look at the excess death statistics. There's no question that it's deadlier than seasonal flu, because the seasonal flu doesn't kill a 9/11s worth of New Yorkers above the usual death rate over several weeks. If the current rate wasn't slowing we'd be looking at a death toll multiple times higher than the seasonal flu.

About 20% of people in NYC showed a positive antibody test. That's not nearly enough for herd immunity and it's not enough to push the infection fatality rate as low as the flu's.

Re: A Third Solution

#20

Post by rguzman »

marcell wrote: post #6

> First of all, it’s not “just the flu”. It is something much more dangerous. Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead I think this is mischaracterizing it. People have to die eventually. One year of existence has a mortality rate of 1%. For a 75-84 year old individual it is nearly 5%. Above 85 it's 14%. [1] The coronavirus infection fat…

the CFR is only as low as 0.5-1% when there is adequate medical care and the population is otherwise healthy. in NYC the CFR for the 18-45 cohort is ~5%[1].

[1]: https://www.worldometers.info/coronavirus/coronavirus-age-se...

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