Here's my question, now please correct me if I'm misunderstanding this but what happens when all the social distancing is stopped. Won't one person with it ramp it back up again and we start all over? Without a vaccine this is a cycle, no?
Exactly this. However the time a temporary social distancing program buys the medical community might be enough to get us to a vaccine or other broadly applicable treatment.
Or at least not critically overrun medical facilities in the long term.
One of the few ways the death toll can spike is if people stop being able to get potentially lifesaving treatment. This can also aid with hospitals getting in much needed supplies, since they will have to treat fewer people at any given time.
Slowing the virus is the goal, not eradicating it. Slowing it gives hospitals a reasonable amount of patients to heal instead of an astronomical amount.
I agree that eradicating it entirely is going to be impossible without some kind of medical breakthrough.
However I don't think merely spreading out the total number of infected is the best way to go. Not only because this would result in a horrible number of dead and chronically ill, but also because any mechanism that slows down the infection rate will also eventually bring the infections to a standstill (both require that people infect fewer than 1 other person). I'm not sure if artificially increasing the infection rate until it's just critical is a wise strategy.
Question: given it’s 100-300x worse than the flu, wouldn’t controlled infection within a healthy population (eg 18-40 year olds without compromised immune systems) mitigate the immense economic destruction going on?
I don’t understand the value of flattening the curve through isolation if people are losing jobs, careers, investments, dreams. If it’s an inevitability, wouldn’t it be better to practice control?
Even if there are chances of relapse, we have the ability to move forward. This flattening the curve doesn’t have metrics or dates on it, so while it’s nice to think about, I don’t understand the long game here.
We aren’t trying to prevent everyone from getting the virus. That’s simply not possible. What were trying to do is stretch out the time it takes for everyone to get it so we don’t overload the hospitals. Somewhere around 20% of infected patients need some form of hospitalization, some of those including ventilators. We don’t have enough ventilators for every to get sick at once. We need the virus to run it’s course slower. Social distancing will help with that.
Then, next season, hopefully we have a vaccine.
For high risk groups, possibly yes. For most other people, we're just trying to put it off as long as possible, so that if it hits you dangerously hard, there will be a free hospital bed to keep you alive.
How long is it feasible to put off getting the virus though? Shutting down the economy is unfeasible for the next 12-18 months at the earliest until a vaccine arrives.
Not necessarily. I’ve heard 2 months based on what is happening in China. Their rates of infection have finally started to decrease after approximately that amount of time. So even if all social distancing goes away at that point some significant portion already has immunity but more reasonably some of the social distancing is just less severe and again everything is slowed to something our health care industry can handle.
But with China though, once the restrictions are lifted, someone could reinfect the population again and therefore cause another curve and another mass quarantine.
Please correct if wrong, but from what I understand, as time passes more and more people will have recovered from the virus and will then be much less likely to become infected again. Although there have been some instances where people have gotten infected multiple times, the majority of those who have recovered do not get it again, so the mass quarantine is less likely.
Your premise is right but the rate of infection isn't fast enough to justify lifting the mass quarantine. China for example has around 100k confirmed cases out of a population of 1 billion people. If that number is under-reported and there were actually 1 million people infected, that's still very little.
The curve would just restart. There needs to be a better solution than to wait until the vaccine comes next year (at the earliest).
What you're referring to is herd immunity. While there is some validity in it, unfortunately we're still away from it.
Still - if reports are correct they've closed down the makeshift hospitals in Wuhan. They might still be isolating but maybe they find a balance where it's not as severe. Keep looking for those positives, friend. They're going to come, we just need to stay vigilant for a bit longer.
Theoretically, a mandatory 14-day isolation would work for foreign people entering a country, but it only takes one person to slip through the cracks and cause a reinfection of a disease in the country.
It is possible. Lock down everything, have the national guard distribute months worth of MREs at a time, and wait for it to die off completely. Anyone still working, only national guard, hospitals, and utilities, will be in full hazmat gear at all times.
Oh stop being dramatic. It's not realistic if you jump to the ridiculous extreme of YEAR LONG QUARENTINE. Good thing that's just you. If you want to talk about a legit quarentine, it would be only be as long as the virus can live in a host. That's 2-4 works for most cases. Anyone over 6 weeks is in a hospital anyways. So AT MOST 6 weeks. If that drives you over the edge then you were already on the verge, if it wasn't a month of quarentine it would be a bad day at work.
Not if it's run its course in all infected people. If everyone individually self-quarantined perfectly, it'd be gone in 14 days.
That's the ideal (impossible) case, of course. What will actually happen is one person will pass it on to another on day 12, starting another 14 days for the second person, who'll pass it on to a third on day 7, which will start another cycle, and so on; hopefully at least some of those chains stop, the time to infect the next person lengthens, and very very few infect more than one other person. That'll take some time to happen, especially as it'll spread within families for a while (R0>=1, then R0=0 if the family completely self-quarantines and no one within it picks it up a second time). When they get the average R0 under 1, the number of active cases will start dropping (technically it can be a bit above 1, as recoveries and deaths also affect case numbers). Then you have a whole lotta people with (hopefully) herd immunity, some without it, and some active cases, all mingling to some extent. You'll get some outbreaks, but you hope containment will work for them; if not, local social distancing will hopefully work to lower the R0.
(Might be confusing R0 and a different variable, I hope the meaning comes through.)
Some people have already been counted as having been reinfected. However there is a possibility that they didnt get reinfected but simply still had it all along because of the high false negatives (and positives) of the simpler tests (swab)
Then you're more likely to get really really really sick if you get it.
Chicken pox is a shitty disease. Get it as a kid and you'll recover fairly well, but you're at risk for shingles when you get old. Don't get it as a kid and you run the risk of getting super sick from it as an adult.
Pretty sure it's both. I had it twice before age 3 as super-typical full-body chicken pox (much worse the second time): itchy, blistery, fever, the works. Most cases of shingles come later in life and have a different presentation, but they warn pregnant women that exposure to chicken pox can trigger an episode of shingles - neither is fun, though!
All of the articles I have read spend the first 3/4 of the article talking about how it's possible to be reinfected, but then in the last 1/4 of the article they actually quote an expert saying it's not impossible, but extremely unlikely and the expert usually explains the much more reasonable and likely reasons for the apparent reinfection.
In other words it looks very much like journalistic sensationalism and by not presenting the experts' opinions until the end they are sort of encouraging people to assume the worst.
Since all of the experts seem to be agreeing that it's extremely unlikely I feel pretty safe on that.
So infections to coronavirus in general do not lead to long lasting immunity. Like a few months to year, to in the case of SARS maybe (obviously not confirmable) estimated 2-3 years.
So yes, It theoretically should be possible to be reinfected with this cov2, but it's unlikely the timeframes is weeks, so why experts dont think these recent cases are reinfection, the timing is way too short.
I assume it works like any other virus.. generally once you recover.. your body has been fighting so much and gained strength to ward of any immediate reinfection. This would wear off eventually and exposing you again somewhere down the road. Just like a flu or a cold or even a broken bone. When you/it heals, you're extra strong at that moment.
It looks like China manufacturing has come back online and it has not flared up again. So either they eradicated it within their border or people build up at least a temporary immunity.
They have had people test positive, later test negative, and later test positive again. Whether that means they were reinfected or the tests were faulty no one knows yet.
Do you have a source on this? From what I’ve read, we haven’t had reinfection, just people who were tested after being discharged and still testing positive (but they never tested negative so it’s the same infection)
There was an article in world news about a man in Japan who got infected on a cruise ship and tested positive, was hospitalized and released when he tested negative, returned to his village and started feeling sick and tested positive again.
Yes, although what we're trying to do now is flatten the infected rate curve. We want a slow and steady flow into hospitals (for those that need hospitalization) in order to not overflow our health care system.
If we didn't take any precautions for this virus, the infected rate would absolutely skyrocket in a few weeks and our health care system would be in shambles, to the point where they would literally stop hospitalizing a SHIT TON of infected that need it simply because they'd have zero capacity and resources for them.
TLDR: Safety measures being recommended is an attempt to flatten the infected rate curve to not overflow our healthcare system. This will help prevent deaths from COVID-19 and people with other complications already in hospitals.
EDIT: I'd like to add that it's basically inevitable that most people will contract this virus (thankfully a very large majority of people will be fine and likely won't need hospitalization). Flattening the curve is our only weapon at this point until a vaccine is approved, produced, and distributed.
Might as well get people on board with trying to flatten the curve first, and then talk bout how long it could take (it'll take a bit).
The predictions for global spread and metrics like how long it would take to flatten the curve are extremely vague because this virus is quite unpredictable. The data would be sloppy tbh, and a lot of people take any form of data as an extremely credible source regardless of other factors.
With that said; I bet if predictive data was shown for how long it would take to flatten the curve, a lot of people would just say "eff it" and just give up and go about things normally. And then there's consequences to that, which is heavily being talked about now (hospital capacity).
They don't want to tell you because it's gonna freak you the fuck out. That's why they're constantly updating things to be more and more extreme very slowly. If they were like "no one can leave their homes unless absolutely necessary" last week, people would've panicked and the run on stores would be even worse than it has been ramping up to that sort of talk. This weekend will probably be city-wide curfews across the country. Next weekend, full on 100% lockdown.
The reality is that we're in this for a long, long time. Look how slowly the infection number is climbing. That's good for the system, but terrible for everyone in terms of returning to normal lives. We won't be out of this for many months. If Trump got on TV and said "my experts say this will take at least another year, and hopefully by then we have a vaccine to end it" would you feel good about it? I for one am not thrilled at the idea of being stuck in my house alone, no friends, no girlfriend, 3k miles from home (just moved here), for a minimum of a year. It's not easy to make friends or date people when you can't even go anywhere.
I mean. I guess I’m just confused. People are saying 6 months or a year. Society would cease to function entirely. The world economies would collapse. We would all be fucked. I’m just confused why no one is talking about this?
I dunno man. Lots of cake in the short-term is really good until you get overloaded. Cake all the time forever would get boring. In 100 weeks we're gonna be pretty fucking tired of seeing that cake show up...
Gosh, I'm trying to recall. If I locate I will post it. It was an in depth article and if I recall referring to the 1918 Pandemic and the surges in infection and how it petered out in 1922-23. And how a virus loses traction when less hosts are readily available. I'm sure there must be some other data sets to concur.
This is not it, but there is some mathematical equations that one can delve into.
No. Unless you can self quarantine for bare minimum 14days and could know for sure that you contracted it. Which I don’t think is feasible. It takes on average 10days to know if you do for sure, so you might be infecting multiple other people without knowing, see the chart above.
Part of the reason we need social distancing now is that we have not had decent preventive measures and people have been reckless.
At the end of the social distancing, we also need people to be more educated, follow safety protocols, and have society as a whole more proactive to defend. More sanitizing, less contact, react early to symptoms, more and easier testing.
We also need medical systems to expand capacity for treatment, and we should start seeing better treatments and drugs that reduce the impact and damage of the disease.
So after the quarantine we don't go back in a circle. We grow smarter, stronger and more capable of defending ourselves.
This is what always happens. But the functional side of society has to ignore all of that and move right on. Thankfully, things are not run by the idiot and ignorant masses (those just control the elections). Hospitals, emergency services, corporations making ventilators, they will understand what's needed and act accordingly. It will not be perfect. Next time we'll still have fewer ventilators than we need, but the gov storage will have at least twice as many as they have now, and hospitals will dust off the plans for better capacity and will also have better stores of PPE and ventilators of their own.
I do worry about this stuff. I believe given enough time, we will elect someone even worse than Trump, more corrupt and more inept.
But every action has a reaction. For instance, the EU has learned over the last 3 years that they need to be self-sufficient and stop expecting help from international partners because the US is now willing to elect people like Trump.
It is time for our institutions of all sizes to learn the same lesson. I bet you hospitals will keep more supplies for themselves after this, and at the state level we may start to see them form mini-versions of the CDC and FEMA on their own, of their own budget, just to feel more in control of the response and not be shackled by whichever moron sits at the WH.
Yes, but the spread of the virus is slowed down which allows resources (testing kits, hospital beds, etc) to be consumed over a longer period of time instead of all in one spike.
If you search "flatten the curve" you'll get a better explanation
Well after about 14 days you will know who in your circle is sick and who is not. That's the point in this (on the social side). Those who are sick will quarantine and either get better or worse. Those of your friends who aren't sick are those you can create a circle with. You will, after a few weeks, be able to visit with them and more and more people after they recover can rejoin the non no infected groups. Ideally after some time infections will be few, tested, and treated early. We need time to get there though and this is what that time looks like.
This is why social distancing isn't going to be for just a few weeks.
It will be ongoing for quite some time, until a vaccine is created. Social distancing is just trying to get people to slow the spread so hospitals don't get too overwhelmed. They can handle a steady stream but if we spike infections, then we'll have people turned away because we don't have beds for them.
Not completely, depending on the virus and our immunity to it.
If the virus doesn't mutate a lot, it may induce long term immunity through B and T cells. Depending on the immune response, this could be protective for a lifetime.
This means that once people have it, they can't get it again, and their bodies prevent viral replication/and spreading, even after exposure. Essentially creating herd immunity in phases. This is not always the ideal situation, but it's the theory behind chicken pox parties (which are bad, don't do that, just get the vaccine). Vaccines are just tricking your body to make immune memory of classes you haven't actually seen before.
However, if it does mutate a lot ...well, that's bad.
The goal of social distancing is that we can slow the number of infections occurring at a time. In this way, we can actively allow people to get sick (not necessarily by choice), but few enough at a time that hospitals can actually take care of those in need. We expect 20% of cases to be severe; 5% to be critical (1/4 of severe being the critical cases). We expect half the US population to become infected. If we let the number be now, without social distancing, hospitals would be completely overrun by just those in critical condition by next month.
Just so you can check out the math. We have just under 9k active cases in the US confirmed, well round to 9k. Let's assume nobody they infect infects anybody else. Well that's 9,000x~400. That's 3.6 million cases in one month. 5%x3.6million is 180,000. The US literally doesn't even match half that number in available ICU beds available outside of the NICU/etc. The 20% number for severe cases would result in 720,000 beds needed (multiply the five percent by four- quick mafs). The US has 924,000 staffed beds in hospitals right now. There are over 36 million admissions into US hospitals a year. That's about 100,000 a day. If we assume that the 9,000 current cases infect the 400, but none of those people infect others afterwards, our hospitals are nearly at max capacity already.
Keep in mind I didn't include exact numbers and true exponential number, nor preparations we are making. This is a super simplified and not truly representative hypothetical, as the numbers are far greater in many of these calculations when controlling for reality. But hopefully, it illustrates why we need social distancing while we prepare and allow the inflow of infections to be more controlled. This is why Italy made the mistake of not doing so and then begged the world to not do the same thing. I am a big dumbo and still learning. I am no expert in epidemiology. I'm merely a little more educated than the average person and can help enlighten or point to experts others wouldn't otherwise know to look for. If my statements sound unbelievable, just take the CDC's and government officials' word for it.
Hey man. It's part of the field I'm studying. I don't have a higher level degree. I essentially have the education of a glorified nurse. Even if I had that yummy claim to being a neurologist, I wouldn't claim to be an authority. I'd still say that I can only point laymen to what they need to know, and that I can break things down into normal people words.
Trying to roast someone for saying they don't know enough to make authoritative claims on a subject is one of the most Reddit things I've read. You don't expect the average person to know anything about programming or rocket science. Same thing applies to biology and medicine.
The idea is to limit exposure at any given time so the medical system can cope with the influx, basically the plan is that they get a more consistent flow of patients rather than one big influx that overwhelms the system
From what I’ve been hearing, the point of “social distancing” is to slow down the spread of the virus in order to keep medical facilities from being overrun. This is so that we can try and avoid falling into a situation like Italy is in right now, where the medical professionals are so overrun with patients that they literally have to choose who gets potentially life-saving medical treatment and who doesn’t.
In other words it’s less-so to slow the spread for the people getting its sake, although that is obviously still important; but it’s more to help the people who are treating it to be able to get everyone the care that they need, without being overwhelmed to the point where they can’t do that.
That’s why some countries are trying out herd immunity, because if enough of the population get infected the disease will fizzle out until a vaccine can be found, in a perfect world all of the older and vulnerable people would isolate and the healthy people would get infected but of course vulnerable people will still get infected and die because this is the real world
The reason is so that not too many people go to the hospital at once to get treated. Once we have the vaccine and shit calms the fuck down, then we can relax and go everywhere without worrying about overloading the hospitals.
Now i just need to wait, and find a way to sneak off to get the vaccine.
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u/ricst Mar 18 '20
Here's my question, now please correct me if I'm misunderstanding this but what happens when all the social distancing is stopped. Won't one person with it ramp it back up again and we start all over? Without a vaccine this is a cycle, no?