I don't understand the Lockdown/shut down exit strategy?


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Can members brighter than myself (the vast majority ;))  explain the exit strategy for current global lockdown/shutdowns?

From where I sit, until there is a vaccine, you lift the foot on restrictions and it likely comes back. 

Herd immunity is spoken of but who is prepared to take the hit of intentional infection?

Where does that leave us?   Restricted in one form or another for 18 months?  The destruction of 50% of most western economies = businesses falling like flies, homes lost, unemployment, suicides through the roof, abandonment of elderly relatives for fear of infection?

So you will shortly have "controlled the curve"

What next?

At what point can restaurants/cafes reopen?  God forbid let's not discuss International travel?

Wuhan is apparently back up and running. Complete lockdown and 9 weeks to take control. Foot off and spot-fires of infection are spreading again. 

I would love to hear members thoughts on how this will likely play out. 

 

 

 

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I do understand what you are saying.  From my perspective, it would be hard to say that this is “overblown” though, because, as a doctor in the 21st century, I have never seen anything like this in my

I personally don't believe a damn thing coming from Wuhan as being credible. China has made most news organizations leave the country.

I am sure others more well versed will chime in but I heard and read that the exit won't really happen until they develop a test to say you are immune for those that develop it and then have some type of treatment (not cure) for the virus while we wait for the eventual vaccine.  

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I'm guessing the shut down or a version of it will last until the cure is developed. I think we only get told 30 or 60 days so we don't all just lose our shit at once. I believe it's a planned dilution of bad news. Meanwhile the muckety mucks are hoping beyond hope that a cure gets developed in extraordinary time hoping this will be over in a few months rather than a year. There is no way that some green flag is going to get waved in the next 2 or 3 months indicating we are free to go about our business as before. This is My opinion only with zero basis in data or other facts. 

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One problem here is that the issue of immunity is not fully understood yet.  Does someone who shows positive on a serological test have a year of safety?  We're not sure.  Since so many (anywhere from 25-40% by most estimates) of carriers never show symptoms, this is a crucial question.  Yes, we need to have a cheap and reliable serological test before we can start executing any sort of midgame (never mind endgame) but we also need to understand COVID-19 immunity better than we do.

Here's a well-written look at the "traffic light" exit strategy the U.K. is reportedly considering.

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26 minutes ago, Chibearsv said:

I'm guessing the shut down or a version of it will last until the cure is developed. I think we only get told 30 or 60 days so we don't all just lose our shit at once. I believe it's a planned dilution of bad news. Meanwhile the muckety mucks are hoping beyond hope that a cure gets developed in extraordinary time hoping this will be over in a few months rather than a year. There is no way that some green flag is going to get waved in the next 2 or 3 months indicating we are free to go about our business as before. This is My opinion only with zero basis in data or other facts. 

Other countries are going the exact opposite route: to underpromise and overdeliver.

Here in Australia, they are talking up a six-month minimum.  In some European countries (Germany and Austria, frex) they speak of a year to even two years.  Personally, I consider it foolish in the extreme to promise a quick end to this slow-mo nightmare without concrete signs that it can be delivered.  

The phase-out of restrictions will be crucial, IMO.  Who do we let work and move first -- the largest industries and sectors to get as many people back into work as possible, or those with the least human interaction to minimise the risk of a flare-up?  Some industries may not need a quick phase-out, either -- call centres, for example, are switching to a "work from home" model as fast as they can, and in a few months' time they will not need restrictions lifted to operate at capacity.  

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1 hour ago, joey rockets said:

In the USA, predictions are that this virus will be an annual event at a minimum.  Otherwise, it seems like the bulk of the nation becomes infected to some degree?

These are just that, predictions. We also predicted, if you consider our “bet it all on black” strategy, that this thing wouldn’t be this big of a deal.

The reality is that we don’t know. I’ve seen prelim data that the virus does not mutate a lot. This bodes well for immunity, a vaccine, and potentially not an annual occurrence. But who knows ?

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1 hour ago, gweilgi said:

...and far more importantly, who has had it and is now immune (at least for a time).

That's the key. When the antibody test results start coming back en masse the big picture will begin to develop. 

I'm really looking at California. The deaths per million are strikingly low. Why? It can't be two days earlier than NY of lockdowns. Sure, NY and NJ are more densely populated but why aren't we seeing SF and skid row in LA decimated?

I believe it's very likey the virus passed through in Dec and Jan without anyone knowing and we're seeing some herd immunity there. Lots of people coming in from China to CA before anyone knew what was happening. It's very plausible and we will see how Sweden's and Holland's approaches work and if it looks similar to CA's situation.

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55 minutes ago, gweilgi said:

Herd immunity: the Brits initially went for it but lost their nerve.  The Dutch and even more so the Swedes are going that way, with minimal restrictions, "intelligent" lockdowns to suppress hot spots and a self-isolation policy based on trust.  We will have to see which approach is less damaging in the long run.

Exit strategies will depend on how much pain a national economy can take.  The media, various "community leaders" and our elected critters are currently still in the "how can we possibly put a price on a human life" mode, but that will change.  It is already painfully obvious to many of us that the voices calling for indefinite lockdowns and even harsher measures tend to be from people in the public sector who have job security no matter what (*).  Every country will be different in this.  The Germans, for example, have massive financial reserves and a far smaller service sector than, say, Australia, and could potentially keep up these policies for a year or longer.  

The game changer, IMO, will not be a vaccine.  Even in the best case, that is a year or more away -- we can only speed up testing so much.  What we need is a quick and reliable test.  Right now, we simply do not know who has the virus, and far more importantly, who has had it and is now immune (at least for a time).  Anyone who has been through the virus could go back to work without fear of being infected or infecting others, and I reckon this would go a long way towards making all those public health measures more manageable.  

 

(*) and who, mindbogglingly, have a tin ear for the suffering of others, such as the attempt in Queensland to grant public sector workers a pay rise or the failure by federal politicians to accept a pay cut.

 

I believe you hit on it, in the US anyway.  Obviously they're not entirely sure themselves, but I have a hunch from the focus on the "who's already been infected and didn't know it" testing capability and the political banter/setup over the efficacy of HCQ.  The political winds among the states will certainly guarantee a lack of uniformity in the approach, but of course the fed controls the moolah. 

Since we all seem to operate with different truths, no matter what it'll be a $hitshow.    

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7 minutes ago, NSXCIGAR said:

That's the key. When the antibody test results start coming back en masse the big picture will begin to develop. 

I'm really looking at California. The deaths per million are strikingly low. Why? It can't be two days earlier than NY of lockdowns. Sure, NY and NJ are more densely populated but why aren't we seeing SF and skid row in LA decimated?

I believe it's very likey the virus passed through in Dec and Jan without anyone knowing and we're seeing some herd immunity there. Lots of people coming in from China to CA before anyone knew what was happening. It's very plausible and we will see how Sweden's and Holland's approaches work and if it looks similar to CA's situation.

IMO California cannot be compared to to NY. Traffic patterns, commuters, and population density are huge factors. Theory that the virus passed unnoticed is bogus, with all due respect. So if NY just let it go unnoticed, then they wouldn’t be in their current situation because of herd immunity. 

 

Sure, California has a lot of Asians, but that would have been more likely to make the West coast an epicenter, not NY. 

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I don’t think the jump California - and especially San Francisco - got on NYC should be minimized.  It came at a stage of the development where a few days or a weeklong head start on lockdown could (and IMO did) make a very significant difference.

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The plan is that there is no plan. Of course. 
I (with no skill in this area obviously) see us in this state for at least 18 months. We don’t have the resolve to do what China did. They literally locked people inside their buildings. Many people who were sick didn’t even make it to hospital and died in their homes. Lucky ones were forcibly removed from their families. These are accounts from people living there. Who knows what’s truth. All I know is I don’t believe a single thing being said about them, it’s pointless to make decisions based on their example.

The most concerning to me is the whole vaccine talk.  We don’t have vaccines for any coronavirus yet.  Sure, previously no first world was being severely impacted by past corona viruses so no one really cared, but still it’s not like we’re going to get something rapidly developed. Imagine the implications of releasing a poorly tested vaccine that needs to be delivered to 5 billion people (because realistically not everyone will have the means to get this) that has a 0.001% rate of consequence that’s up killing 50,000 people. 

 

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22 minutes ago, Jaesian said:

Sure, California has a lot of Asians, but that would have been more likely to make the West coast an epicenter, not NY. 

I think you've illustrated my point. Why isn't CA an epicenter? The homeless populations of SF and LA should be getting walloped. Much denser populations than anywhere in NY and higher risk factors. 

And why are Vermont and Massachusetts getting hit so hard?

Also, it's not just that it's an Asian population in CA per se, but just that much of the China travel to the US lands in CA first. 

 

5 minutes ago, Deeg said:

I don’t think the jump California - and especially San Francisco - got on NYC should be minimized.  It came at a stage of the development where a few days or a weeklong head start on lockdown could (and IMO did) make a very significant difference.

CA was only 2 days ahead, and NY is 10 times worse. I'm sure it had some impact but I'm not convinced it explains all of it.

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So much about this pandemic doesn’t make sense. I keep going down rabbit holes only to end up with more questions than answers. Which I think is a big problem. And yet, some are super confident of their opinion...which is almost entirely that at this point - opinion!  My view is to stay fluid and open to all the possibilities. All while staying safe. 
 

 

A wise old owl lived in an oak
The more he saw the less he spoke
The less he spoke the more he heard.
Why can't we all be like that wise old bird?

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2 hours ago, Danbar99 said:

The issue is not preventing people from being infected at this point.  Its about making the initial wave of infections peak small enough that hospitals and healthcare systems can cope.  Running out of healthcare resources, be it beds, medicines, etc. is when more die.  Hopefully once the first giant wave has passed, the future waves will naturally have lower peaks due to more people with immunity from getting it prior times.  It will still suck, but the hope is the healthcare system can handle better.

This above is my thoughts.

As for homeless not getting hit hard? Is it possible that BECAUSE they are outside in the open, and while somewhat close to other homeless folks, they are certainly not all jammed together in businesses, buses, trains, planes,resturants, etc?? 

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40 minutes ago, NSXCIGAR said:

I think you've illustrated my point. Why isn't CA an epicenter? The homeless populations of SF and LA should be getting walloped. Much denser populations than anywhere in NY and higher risk factors. 

And why are Vermont and Massachusetts getting hit so hard?

Also, it's not just that it's an Asian population in CA per se, but just that much of the China travel to the US lands in CA first. 

CA was only 2 days ahead, and NY is 10 times worse. I'm sure it had some impact but I'm not convinced it explains all of it.

I think you’re coming to a different and not the correct conclusion, in my opinion, but I am too tired to thoughtfully write a response. California may have a higher density, and I haven’t fact checked this, but I feel that California has more commuter traffic rather than the public transit in NYC. As for the homeless population, it’s one thing to be outside homeless than it is to be a working person using the train everyday and exposing yourself to new people by the second. 

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I first read this as the locker shutdown/exit strategy. That's already underway.

Agreed the primary goal seems to be "flattening the curve" to minimize overwhelming the heath care system.

Don't believe there will be a mass unleashing of the populace. More likely a controlled release. Will be interesting to see how the leaders come up with priorities for that.

There will be the occasional (or frequent) hot spots pop up. Contact tracing may become the norm everywhere.

Strange days.

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2 hours ago, NSXCIGAR said:

I think you've illustrated my point. Why isn't CA an epicenter? The homeless populations of SF and LA should be getting walloped. Much denser populations than anywhere in NY and higher risk factors. 

And why are Vermont and Massachusetts getting hit so hard?

Also, it's not just that it's an Asian population in CA per se, but just that much of the China travel to the US lands in CA first. 

 

CA was only 2 days ahead, and NY is 10 times worse. I'm sure it had some impact but I'm not convinced it explains all of it.

Likely it’s a number of things, and of course I don’t know anything, but my pet theory is public transportation. Those of us on the west coast talk a big game about public transportation, but we don’t rely on it like the east coast cities do. Most of my family still lives in the Seattle area and when the city was going whole hog building every kind of tram, train, light rail, underground system, funicular, trolley, donkey cart system, etc., it was a huge source of conversation in my family about how it would change everything......yeah, the northern contingent of the family is still all driving SUVs through downtown Seattle.

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21 minutes ago, bpm32 said:

...my pet theory is public transportation.

Might certainly be something to that. I don't know what the public transportation systems are like in Detroit, Chicago or New Orleans but they're all getting hit relatively hard.

And it still doesn't explain MA, VT, RI and CO that have limited public transit. VT and CO, in particular have extremely low population density. 

And while CA is very low, WA is still quite high. But if the virus was working it's way through the west coast in Nov-Dec surely WA would look like CA.

There are definitely some geographical oddities with this that may take a very long time to sort out. Again, antibody testing will tell us quite a bit about how this is moving and when.

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12 minutes ago, NSXCIGAR said:

Might certainly be something to that. I don't know what the public transportation systems are like in Detroit, Chicago or New Orleans but they're all getting hit relatively hard.

And it still doesn't explain MA, VT, RI and CO that have limited public transit. VT and CO, in particular have extremely low population density. 

And while CA is very low, WA is still quite high. But if the virus was working it's way through the west coast in Nov-Dec surely WA would look like CA.

There are definitely some geographical oddities with this that may take a very long time to sort out. Again, antibody testing will tell us quite a bit about how this is moving and when.

All solid points, and it’s worth saying this thing isn’t anywhere near over and I hope our luck holds.

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The first hotspot in the U.S. was the greater Seattle area.  It had a head start on everywhere else.

Now, for the record, WA is out of the top 10 states in terms of infections and deaths.

 

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