The San Francisco Bay Area shelter-in-place order is being extended through May • Hacker News Board

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#141

Post by SnowProblem » Mon, Apr 27, 2020, 9:41 PM UTC

cs702 wrote: post #104

scott_s wrote: post #29

Earlier quoted context omitted.

I've seen you say similar things in a few other threads, and myself and others have said, every time: the risk to everyone is that the hospitals become overwhelmed. They are not right now because of stay-at-home orders. What you think of as failure - hospitals currently low utilization - is in fact success .

If many people get very sick simultaneously, they would not only overwhelm hospitals, they would also inflict a disorderly, involuntary shutdown of large swaths of the economy, driven by fear -- instead of the orderly, voluntary shutdown we have at present, driven by government mandate. We all want to avoid a disorderly shutdown driven by fear.

Your definition of voluntary is entirely different from mine.

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#142

Post by lbeltrame » Mon, Apr 27, 2020, 9:41 PM UTC

ars wrote: post #18

marcell wrote: post #5

Blanket lockdown has to end. This policy has outlived its usefulness, and is harming people's quality of life without a clear goal. The initial premise of the "flatten the curve" memes was to avoid overwhelming hospitals. The shelter-in-place has not only had this effect, it's been too effective. Hospital utilization in the bay area is at around 10% when you count surge capacity that has been added [1]. Meanwhile, da…

I've been wondering for a while what the end game is. There seems to only be 3 options: 1: Lockdown forever. 2: Everyone becomes immune. 3: Vaccine. 1 is unrealistic. 3 will take a year. 2 the lockdown is too effective - we need at least some people to get infected, and hospitals to be utilized at a manageable rate. Is there a 4th option I did not think of? Because I can't figure out how they are going to end this. I…

> Is there a 4th option I did not think of? Because I can't figure out how they are going to end this.

Pharmacological treatments, I'd say.

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#143

Post by ttul » Mon, Apr 27, 2020, 9:41 PM UTC

newacct583 wrote: post #95

cpncrunch wrote: post #64

Earlier quoted context omitted.

Here in BC we don't have such restrictive conditions, and yet we still have very few cases. Vancouver has about 76% of the population of SF, but has half the number of cases. Restricting people to be at home has no benefit, no logic behind it, but has significant repercussions on mental health.

My understanding is that the Vancouver lockdown is largely identical to the California one, no? What is open there that isn't in CA? I know restaurants, theaters, large gatherings, etc... are all closed, which is the economic activity most of the "reopen" people are concerned about. Edit to note: two responses "disagreeing" with me by pointing out that the BC lockdown is effectively the same thing as the California o…

First, it's not a Vancouver lockdown (it's a BC thing), nor is it really a lockdown at all. Nobody is legally required to stay at home except for people who are under a specified health order. Here are the restrictions on life that are most commonly noticed:

1. Restaurants are closed except for take-out and delivery. 2. Personal services businesses are closed. 3. Large gatherings of all kinds are banned. 4. Schools are closed.

You can still go to your office if you wish to, so long as social distancing rules can be respected (staying 2m apart). This being said, the vast majority of businesses that can have their employees work remotely are doing so, simply out of a concern for their health and wellbeing. If you have to have employees in your workplace, then there are guidelines for making it as safe as possible.

There is also extensive testing. Anyone with symptoms can be tested promptly.

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#144

Post by greendave » Mon, Apr 27, 2020, 9:41 PM UTC

The problem is that the shelter-in-place rule is already limited in effectiveness due to a very lengthy list of exceptions plus many people not observing the spirit of the rule. Compliance will only drop over time as people see that 1) Their actions are having no obvious impact and 2) There is no clear end in sight.

If the primary goal of extending the order is to give local governments time to build out infrastructure, that's fine (though they would do well to communicate this progress to the public). But if the primary goal is to further reduce transmission, I can't see it being successful.

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#145

Post by jupp0r » Mon, Apr 27, 2020, 9:41 PM UTC

marcell wrote: post #5

Blanket lockdown has to end. This policy has outlived its usefulness, and is harming people's quality of life without a clear goal. The initial premise of the "flatten the curve" memes was to avoid overwhelming hospitals. The shelter-in-place has not only had this effect, it's been too effective. Hospital utilization in the bay area is at around 10% when you count surge capacity that has been added [1]. Meanwhile, da…

> Blanket lockdown has to end.

What's different now vs before the lockdown started regarding flattening the curve? R0 is a little under 1 right now, but what will it be when most things reopen?

The goal of the lockdown is to keep R0 under 1 until we have measures in place to permanently mitigate the spread [1]. This means lots of testing and contact tracing, which is not even possible right now with case numbers being as big as they are.

Reopening right now would just get us back to #flattenthecurve in a matter of 4 weeks.

> There is no risk posed to the majority of the population from covid-19

There is risk to everybody, it's just lower for some. There's enough evidence of permanent damage inflicted on organs and other gnarly details that I (34M) will be absolutely careful not to get this disease. [2]

[1] https://www.gov.ca.gov/wp-content/uploads/2020/04/California...

[2] https://nymag.com/intelligencer/2020/04/more-bad-news-on-the...

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#146

Post by jshevek » Mon, Apr 27, 2020, 9:42 PM UTC

HarryHirsch wrote: post #92

marcell wrote: post #5

Blanket lockdown has to end. This policy has outlived its usefulness, and is harming people's quality of life without a clear goal. The initial premise of the "flatten the curve" memes was to avoid overwhelming hospitals. The shelter-in-place has not only had this effect, it's been too effective. Hospital utilization in the bay area is at around 10% when you count surge capacity that has been added [1]. Meanwhile, da…

In New Zealand, South Korea and Australia coronaplague is on the way out thanks to testing and contact tracing. Why can't the US muster the political will to do the same? We are already seeing the damage because a number of meatpacking plants had to go off-line when a substantial part of their workforce was ill and could not report to work, yet many citizens advocate for even lighter restrictions. Nothing of this mak…

>In New Zealand, South Korea and Australia coronaplague is on the way out thanks to testing and contact tracing. Why can't the US muster the political will to do the same?

When it comes to complete elimination, you leave out the most important ingredient: all three countries have fantastic border control, thanks to geography in two cases, and an extremist neighbor in the third.

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#147

Post by joe_the_user » Mon, Apr 27, 2020, 9:42 PM UTC

cactus2093 wrote: post #41

killion wrote: post #2

We are down 50% from the peak of Covid deaths in California. It seems likely we will have one or more days of zero Covid deaths before the end of May. That is the measure I assume they are going for at this point. Source: https://covid19.healthdata.org/united-states-of-america/cali...

This is untrue. We may have plateaued but we haven't yet seen a significant drop from the peak yet. 4 days ago there were 115 deaths, then 93 the next day, then 89 the next, that's as high as the peak you're referring to. Source - daily department of health releases https://www.cdph.ca.gov/Programs/OPA/Pages/New-Release-2020.... The drop you are inferring from your graph appears to be a be a reflection of a noisy dat…

Remember death rates are an effect that's delayed several weeks. Positive tests are skewed by how many tests are done. Hospitalizations would be a better figure but those don't really seem to be available on a daily basis. This chart claims to show but it's 212 one day and zero the next, which just showing they're aggregate or something.

https://covid-19.direct/state/CA?tab=daily

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#148

Post by AndrewBowman » Mon, Apr 27, 2020, 9:42 PM UTC

ars wrote: post #18

marcell wrote: post #5

Blanket lockdown has to end. This policy has outlived its usefulness, and is harming people's quality of life without a clear goal. The initial premise of the "flatten the curve" memes was to avoid overwhelming hospitals. The shelter-in-place has not only had this effect, it's been too effective. Hospital utilization in the bay area is at around 10% when you count surge capacity that has been added [1]. Meanwhile, da…

I've been wondering for a while what the end game is. There seems to only be 3 options: 1: Lockdown forever. 2: Everyone becomes immune. 3: Vaccine. 1 is unrealistic. 3 will take a year. 2 the lockdown is too effective - we need at least some people to get infected, and hospitals to be utilized at a manageable rate. Is there a 4th option I did not think of? Because I can't figure out how they are going to end this. I…

The idea is not just to keep the curve low initially and then abandon all measures, but to figure out how to keep the curve consistently low over time until a vaccine or highly effective treatment is discovered.

Basically, when you're in free fall and the parachute slows you down comfortably, don't take that as the cue to cut your chute.

Also you may have overlooked adequate testing availability and contact tracing.

And even if contact-tracing is lagging, an abundant supply of testing can at least help to ensure that symptomless or incubating-but-not-showing-symptoms-yet infections can be identified early to prevent wildfire-type spread.

My guess would be that with more tests and resources available, start with a stuttered type approach, open for 2-3 weeks, then lockdown for 2-3 weeks while we wait for new infections to manifest symptoms and for infected to quarantine until they're not infectious.

That could serve as a baseline for what to watch for during reopening, to gauge risk as to whether to repeat with some alteration in timing.

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#149

Post by amluto » Mon, Apr 27, 2020, 9:42 PM UTC

BurningFrog wrote: post #82

marcell wrote: post #5

Blanket lockdown has to end. This policy has outlived its usefulness, and is harming people's quality of life without a clear goal. The initial premise of the "flatten the curve" memes was to avoid overwhelming hospitals. The shelter-in-place has not only had this effect, it's been too effective. Hospital utilization in the bay area is at around 10% when you count surge capacity that has been added [1]. Meanwhile, da…

I think this is a lot like finishing your full 7 day medication treatment, even though you feel fine on day 3. That said, I don't know when and how the right way to wind down is, and I don't think anyone else does either. I'm glad we're doing this in a decentralized way over 50 states, so many different strategies can be tried. I would also add that we who can WFH with full wages do well to remember millions of alrea…

When you take a 7 day course of antibiotics, you are reducing your bacterial load to a level at which it is highly unlikely to bounce back from zero and, critically, the chance that it bounces back and selects for resistant strains is comfortably low.

No one seriously expects any length of shutdown in the US to reduce the case count enough to eliminate COVID-19. Worse, even if we reduce the case count to an unnoticeably low number, we’ve made essentially no progress toward a suppression strategy that will detect and control new cases to avoid another shutdown.

Re: The San Francisco Bay Area shelter-in-place order is being extended through May

#150

Post by akira2501 » Mon, Apr 27, 2020, 9:42 PM UTC

scott_s wrote: post #29

marcell wrote: post #5

Blanket lockdown has to end. This policy has outlived its usefulness, and is harming people's quality of life without a clear goal. The initial premise of the "flatten the curve" memes was to avoid overwhelming hospitals. The shelter-in-place has not only had this effect, it's been too effective. Hospital utilization in the bay area is at around 10% when you count surge capacity that has been added [1]. Meanwhile, da…

I've seen you say similar things in a few other threads, and myself and others have said, every time: the risk to everyone is that the hospitals become overwhelmed. They are not right now because of stay-at-home orders. What you think of as failure - hospitals currently low utilization - is in fact success .

> What you think of as failure - hospitals currently low utilization - is in fact success.

What bothers me is the contention that my rights are contingent upon reported capacity of already existing hospitals. If this is truly a concern, and our rights our primary, then we should be building more hospitals so that we no longer have to make this Faustian bargain.

It seems impractical and short-sighted to continue these measured based upon this single metric, especially when there are so many other ways to have a lasting impact on the problem.

Aside from that, I don't personally believe it's the purpose of the government to save lives at any cost. Even the Police won't give you that guarantee.