HN Theater @HNTheaterMonth

March 2015: https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re...

He could have used the TED platform to talk about anything, and he chose to raise the alarm bell about pandemic preparedness. A fairly niche and unpopular topic at the time.

Not to mention Gates who warned of this barely five years ago

https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re...

Bill Gates also knew about this threat for years, and so did the audience who watched that talk

https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re...

Just saying, there is plenty of blame to go around for all of us, once this pandemic crisis is resolved.

⬐ mav3rick

Lol Bill Gates is not an elected official. He has arguably more than enough for a private individual.

⬐ foogazi

Yeah, though at some point you have to ask the question:

“Where does the buck stop?”

https://en.m.wikipedia.org/wiki/Buck_passing

We over index on preparedness for war. Bill gates has a great ted talk on this who basically called this corona virus situation a few years ago. https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re...

When I look at the whole situation it looks like a bunch of meatheads whose answer to everything is brawn and military superiority.

⬐ danans

The dust hasn't settled on this yet, but it appears that countries that are in a siege military footing (S. Korea, Israel, Cuba, Taiwan) have done better in controlling this situation because they have strong universal health systems and institutions coupled with mentality of constant preparation for a military siege. The culture of real preparedness is present throughout those countries' institutions, military or not.

This was discussed by Max Brooks on Fresh Air yesterday:

https://www.npr.org/2020/03/24/820601571/all-of-this-panic-c...

What Brooks doesn't discuss is the extent to which those countries have varying degrees of authoritarianism or the tendency for citizens to voluntarily comply with public orders.

In the US however, our military stockpiling is geared toward propping up defense industries. This has value to a point, but only when its objectives are actually defense preparedness, but not when the objectives are profit maximization.

The military is no substitute for having properly resourced and coordinated national institutions to deal with huge public health issues.

⬐ magicsmoke

The difference with those four countries is that they expect fighting a war on their own soil to be a future possibility. When's the last time Americans actually saw what war on their doorstep looks like? The civil war? America's real defense is the Pacific and Atlantic. The US military is a raiding force that's free to attack anywhere in the world without fear of retaliation because they know the American continent is geographically unassailable.

⬐ simonblack

they know the American continent is geographically unassailable.

That's 'magical thinking'.

No doubt the Japanese thought pretty much the same in 1942. That's why the Dolittle Bombing Raid on Tokyo was such a shock to their systems.

⬐ ethbro

The Doolittle Raid was military insignificant, and in no way should have altered Japan's belief that their home islands were geographically unassailable.

Even in 1945, with the Imperial Japanese Navy suppressed or destroyed and their supply chain in tatters, an invasion would have been incredibly costly.

Occupying enemy territory, across an ocean, with a large population of civilians disinclined to cooperate, is never easy.

⬐ danans

> they know the American continent is geographically unassailable.

And COVID19 is turning that assumption on its head. The only question that remains is whether the US can buttress what's left of its public health institutions to keep it at bay, and prepare for the next wave that comes, whether of this pandemic or the next one.

⬐ ethbro

I don't remember a H1N1, SARS, or MERS outbreak in the US.

Borders are absolutely a defense, they're just not an absolute defense.

That SARS-CoV-2 was able to spread globally as a pandemic has more to do with its transmissibility and latency characteristics.

⬐ danans

> That SARS-CoV-2 was able to spread globally as a pandemic has more to do with its transmissibility and latency characteristics.

Which is what proves that the US isn't unassailable from a pandemic. It would be a mistake to assume that SARS-CoV-2 or something with similar ability to breach geographical barriers won't occur again. Also, nature doesn't care about political entities, and a pandemic could also start in the US.

⬐ ethbro

It isn't, but it would generally be a waste of resources to overprepare for something that has a low probability of happening. In the same way it would be to fortify both coasts.

Budgeting is a zero sum game.

Stockpiles of essential PPE, sure. Pervasive monitoring for early detection? Not worth it.

⬐ mistermann

> When I look at the whole situation it looks like a bunch of meatheads whose answer to everything is brawn and military superiority.

I'm not overly familiar with how the US medical system works at a detail level, but is it illegal for individual hospitals, clinics, dental offices, etc to independently stockpile critical supplies?

⬐ vajrabum

No, but hospitals are mostly for profit in the US so they don't. They run lean so as to make the best return on investment. That's also why we have as few hospital beds as we do. Most US hospitals used to be non-profit. When they were converted to for profit institutions there was a concerted decades long effort to reduce hospital stays and the beds that requires. Completely understandable given the need to make as much money as possible.

⬐ mistermann

Yes, this seems like the obvious explanation to me as well.

My question was regarding the other poster's proposed explanation: "When I look at the whole situation it looks like a bunch of meatheads whose answer to everything is brawn and military superiority."

Simple profit maximization seems like a much better fit to me.

I suspect if we were to sit down and do an actually proper post-mortem on this debacle, it would mostly reveal a giant pile of simple explanations like this. I doubt this situation is nearly as complicated or conspiratorial as most people are making it out to be. Rather, it is simply optimizing for a particular variable, and if people aren't smart enough to realize that other variables are going to suffer correspondingly, and this low quality of thinking becomes prevalent enough that it becomes a literal existential threat, then I think it's about time the citizens of planet Earth put down their weapons for 2 or 3 months, and had a serious conversation.

I believe that if people continue to communicate in literal untruths, often knowingly, it will not be long until our demise as a species. Covid-19 feels to me like a warning from a different dimension. Whether this is literally true, if conceptualizing it in this way helps people to actually fucking think for a change, I say let's roll with it, or whatever other weird psychological sleights of hand get the job done. And I suggest we do it fast, because if we continue on this same downward trajectory (with increasing speed), it may not even take an anomalous event like this for us to wipe ourselves out.

I think we need some new ideas. I feel like we have to form a new internet community of some kind, not unlike what we have now (reddit, the software itself with a few minor feature additions & subtractions, would be more than sufficient). The main change, the change that I believe would make the difference, would be extremely strict new guidelines around acceptable behavior, that are enforced with extreme prejudice.

I actually believe there is one single rule that could fix the overwhelming majority of these problems, and here it is:

> RULE #1: It is completely forbidden to say things that are not true. Ever. Violations of this rule will result in increasingly severe punishments, ultimately resulting in a permanent ban.

Read that sentence, and be careful your mind doesn't start automatically generating ideas that prove it "impossible" (this word, like so many others, no longer has a common shared definition) - if it does, just make it stop and return to reading the sentence. Try to bring a sense of peace into your mind, it is likely not going to like that so it will be a struggle, but hang in there. Try to contemplate what is truly being said here, truly consider if "only say things that are true" is really such a ridiculously high goal, at least for us to aim towards.

Is this not very similar (but more stringent) to what our parents taught us when we were growing up? Is truthfulness too much for us to even try for at this point in humanity's evolution? If I am the only one that sees this as an attainable, righteous, and pragmatically useful goal, then I'm not really sure if I want to be here any more. I feel like I don't have anything in common with anyone. I don't like what Earth is becoming. I feel like an alien here, like I am of a different kind of some sort, like I don't belong here, like I have somehow wound up in the incorrect dimension.

Can no one else see what I'm talking about? Have I completely lost the plot? Someone has to do something. I wish someone would at least try. I wish someone could at least even admit that there's a problem. If we can't even agree that there's a problem, and roughly what the nature of that problem is, or even agree that this is something worth looking into, I feel like we should just wrap this whole thing up, because our days are numbered anyways.

⬐ danans

This points to an obvious bit of legislation that we need in the US: require hospitals to keep minimum stockpiles of pandemic response supplies, just like banks have minimum financial reserve requirements.

⬐ ethbro

Given that there's an accute shortage of hospitals serving rural areas, regulation of that nature better be accompanied by federal funding for that work.

I wouldn't be surprised to see some serious DHS money redirected to hospitals, after this is all over. They could certainly put it to better use than police departments.

⬐ mistermann

Alternatively, you could assign maintaining the mask inventory to admin staff. I know they often don't have advanced degrees, but I can't imagine they'd do a worse job of it. Actually, they'd probably take the job a lot more seriously than the "experts" who are in charge currently.

Assigning such tasks to a central body seems like an extremely fragile design, and as evidence for this assertion, I offer the current state of reality. I find it a rather convincing argument, but then I'm probably quite biased.

⬐ throwaway32120

And like most things in America, the military costs much more than other countries and does much less for its citizens. A good example is what happened when Yemen fell apart: China used its military to evacuate Chinese citizens[1], India used its military to evacuate its citizens[2], and the US told its citizens that they were on their own[3]. The American embassy even told Americans trapped in Yemen that they should seek out the help of India in order to get out of the country[4]. It's hard to escape the notion that for decades America has suffered under a political class that's been a mix of incompetent, self-serving, and uncaring.

[1] https://www.bbc.com/news/world-middle-east-32173811 [2] https://en.wikipedia.org/wiki/Operation_Raahat [3] https://foreignpolicy.com/2015/04/21/washington-to-americans... [4] https://www.washingtonpost.com/news/worldviews/wp/2015/04/08...

⬐ Gibbon1

I've read that same thing about the 2004 Boxing Day Tsunami. Other countries worked hard to help their citizens and get them out. The US just abandoned theirs.

⬐ merpnderp

No one paid attention. After the H1N1 crisis, the US burned through its reserves of N95 masks and other pandemic supplies, and never refilled them.

We aren't even learning now, even after it was obvious Italy needed to lock down more, the US still wasn't taking it seriously. I listened last night to my city council argue that it was still no big deal. Two members, a doctor and scientist said we needed to shut down the city, and everyone else arguing it would destroy small businesses and it wasn't that big a deal to anyone but the elderly.

We just don't learn.

⬐ throwaway5752

This is a case where not being specific about blame is not serving accuracy. Many people were paying attention. WTO was on this from the beginning of the year. China essentially cancelled the New Year festival nationwide and locked down 60 million people on Jan 23. The administration was warned specifically about this situation by the military and intelligence communities beginning in January. The administration is actively pushing the, "cure cannot be worse than the disease" messaging against expert advice. Anthony Fauci was notably removed from the daily briefings after he criticized the same things you are criticizing. Experts know this stuff, and for some reason you see lockdowns in states like WA, CA, NY/NJ/CT/PA, MI, OH absent federal direction but not in places like FL or MS. I think you have to explain why attitudes like https://www.jacksonfreepress.com/news/2020/mar/23/governor-r... are along partisan lines, and the source of those attitudes.

⬐ xwdv

What if what we learned is simply that there’s nothing we can do?

You can lock down, you can isolate... destiny still arrives.

⬐ fatjokes

Avoiding infection was never the goal. "Flattening the curve" so as to not overwhelm the fragile health infra is, and it's already been shown to be working.

⬐ spuz

Then fine, we just keep moving on and accept deaths from the virus in the same way as we do for deaths from the flu or road traffic accidents. However that is absolutely NOT the situation we are in. If we do nothing, significant numbers of people will die from the virus. If we completely shutdown the economy, significant numbers of people will die from lack of access to essential services. What we decide to do matters a great deal. There is no reason to be fatalistic.

⬐ eternalban

You are making assumptions here.

I'm working on a joke and only have the punchline: "Western Democracy with Chinese Communist Party Characteristics".

⬐ chrisco255

20-50 year olds with no pre-existing conditions are at low risk. The policy of shutting down the economy indefinitely is frightening on its own and we'll be dealing with the steep repercussions of that for many years. This is not sustainable.

⬐ m_mueller

Japan shows that wide use of masks, good hygiene and a decent HC system should actually allow to keep the country running. After what's happened so far, I wonder whether Western countries will be able to learn from this - it's going to need lots of politicians to walk back on previous statements.

⬐ claudeganon

Japan shows nothing besides doing a better job of the appearance games that US tried and failed to play. Everyone I know in Japan is saying the response is a disaster and bracing for the worst. There was a huge uptick in cases just reported and the media is starting to break their government-imposed silence and warn people.

⬐ bigmanwalter

Those aren't mutually exclusive. Japanese people can accuse their government of not responding effectively even though the Japanese government is doing a better job than the US.

⬐ claudeganon

From all the news I’ve seen (I watch Japanese news broadcasts most days), people there aren’t comparing the Japanese response to the US, but Taiwan, South Korea, and China. And the comparative failings are obvious and stark.

⬐ m_mueller

I'd say Japan is pulling through despite failings of the government. I don't think their #deaths is cooked much.

⬐ claudeganon

They’re literally not.

I watched the news this morning and the broadcasters were panicked at a level I haven’t seen since 3/11. No meaningful measure have been put in place to curb the spread of the disease or strengthen healthcare infrastructure in Japan.

But Aso Taro, a leading politician of the ruling LDP, did announce his major response initiative: giving out certificates for Wagyu beef.

⬐ m_mueller

Ok, could be. I hope not for them, but let's see how it goes down.

⬐ baq

Now that Olympic Games are cancelled they don’t have much reason to cook numbers anymore. I expect a gradual change in tune of official communication starting immediately.

⬐ johnchristopher

Some European countries weren't as deep into bad HC as the US so there are going to be a wide range of reactions and adaptation. Weird thing: in my country, the political entities responsible for budget cuts in HC are applauded at the moment for their handling of the situation they made worse because of those previous cuts.

⬐ chrisco255

We have an expensive healthcare system in the U.S. but it's not a bad healthcare system.

⬐ bigmanwalter

Depends on whether or not you have a job.

⬐ johnchristopher

Sorry, I abused the language. I'd say you have good healthcare but a bad healthcare system.

⬐ amluto

They may be at low risk of death, but not of transmitting the disease. When the economy reopens, we need real measures to reduce transmission.

For example, all businesses with more than one person or with customer contact (including not-quite-employment situations like UPS or ride sharing) should take everyone’s temperature every day. Feverish or otherwise sick employees should be sent some, with pay, and there should be very strong disincentives for managers to encourage their employees to pretend to be healthy.

For another example, everyone on public transit or otherwise in a crowded place should wear a mask. If a real surgical mask is not available, a couple of layers of fabric should still help.

⬐ misun78

This comment applies to any viral disease that spreads amongst humans. What warrants a complete shutdown this time around when we didn't do the same for H1N1, SARS etc?

⬐ amluto

I’m not personally convinced that a complete shutdown is the right choice. But SARS wasn’t very contagious and only had a few total cases in the US. Arguably H1N1 should have had a somewhat stronger response. Also, people are used to the flu and it’s not as scary.

(Also, there wasn’t really any research needed to vaccinate against H1N1. It was just a matter of production. On the flip side, the flu mutates very quickly to evade immunity, whereas coronaviruses seem to mutate very very slowly. A COVID-19 vaccine that works* seems likely to provide protection essentially forever.)

* Early indications were that the obvious vaccine design for SARS made the disease worse, not better. That’s why we haven’t seen much excitement about inactivated COVID-19 vaccines.

⬐ rovolo

SARS was much more contained, and only infected ~8K people. It infected ~3K people outside of China, most whom were in east Asia. The case counts outside east Asia were in descending order:

- Canada: 250

- US: 27

- Germany: 9

Areas affected by SARS instituted targeted quarantines after detection and were able to contain the virus.

https://en.wikipedia.org/wiki/2002%E2%80%932004_SARS_outbrea...

H1N1 was much less deadly than Covid-19 and spread less quickly. There were only ~18K confirmed deaths worldwide. (The estimated number of deaths was much higher at 150-600K. Basically, we confirmed it was less deadly than the seasonal flu so we didn't test everyone for it.)

https://en.wikipedia.org/wiki/2009_flu_pandemic

People are freaking out about Covid-19 because it spreads faster and is already stressing hospitals. Deaths and cases double every 2-3 days absent control measures. It can take 2 weeks to cause symptoms, so even if everything gets shut down now, we could have 25x as many hospitalizations/deaths than today. If smaller control measures aren't as effective, it'd take time to confirm and the peak would be multiples higher. H1N1 spread much slower so we could have responded much more leisurely if things started to go out of control.

https://www.ft.com/coronavirus-latest

⬐ wastedhours

Well, you can kick things off by sacrificing any member of your family over the age of 50 then.

It's almost as if people don't realise economies are reliant on people to contribute to them. You infect half the population you're going to have the same effect regardless. Only this way, we might not end up killing millions unnecessarily.

⬐ CerealFounder

Its pretty simple. We didn't scale testing at all which turns a national isolation into just isolating people that are potentially infected. Then you keep isolating those people until it dies on the vine. This current solutions SUCKS, but it silver medal sucks to just letting the disease roam free and infect everyone.

Also, the whole "young people and what not are at low risk" is anecdotal. We have no clue what the longterm, and passive ramifications of this virus are.

⬐ enumjorge

So do we treat anyone outside the group of 20-50 year old with no preexisting conditions as acceptable collateral damage to keeping the economy afloat?

⬐ misun78

We quite literally do do what you're saying with general influenza that also takes folks outside the 20-50 range as collateral damage to keep the economy float. Hence your comment is meaningless without understanding how much more severe and infectious covid-19 is.

⬐ chrisco255

Collateral damage? There's no vaccine for this disease and we may not get one for years. We have to develop immunity for it at some point. We can't live in a bubble. A body in quarantine is safe but that is not what bodies are for.

⬐ Klinky

It's almost as if some people think human's purpose is to sustain an economy, rather than the other way around.

Economies and markets are a tool used by human's to achieve goals(ideally better quality of life), they are not the goal itself.

⬐ jjeaff

It seems like you are making their point for them.

If an economy's purpose is to sustain humans, then letting it crash and burn puts those humans at risk.

It's a balancing act. We just can't forget that too much economic destruction will cost lives as well.

⬐ Klinky

It is a balancing act, but we need to watch out that we're not letting the economy run the show based on things like overinflated valuations and speculation, which at the first sign of trouble, implode on themselves at almost a 50% loss.

How much actual value(quality of life) is really being generated here? How much of it is hype, bandwagons, and charades? How sustainable is it and what safety nets are available when the bottom falls out? During this time you also think about how many people are telecommuting effectively right now, and how much downtown economies and real estate relies on everyone getting in their car, or on a bus/train going downtown each morning, and then the knock on effects this has on the environment.

A lot of people don't want to hear pessimism or realism, they want to see growth, growth and growth. Growth at all other costs can still result in the side effect of quality of life improvements, but unlimited economic growth has not been sustainable, and we've had quite a few boom and bust cycles the last 2 decades now. If you're designing the economy to continually boom & bust, it's hard not to expect eventual economic destruction. It's not a matter of "not letting it happen", it's a matter of that's how it's been designed. It's what it does.

⬐ wbronitsky

The alternative is a wildly increased death rate, which you cannot reverse. There are so many ways to fix economies, only a few ways to address a pandemic.

If you do not have another solution that keeps people alive, kindly be quiet; you have nothing important to say.

⬐ chrisco255

There's only so many trillions of dollars the Fed can print before the whole structure of the economy buckles. And when economies buckle, death and despair ensue. The economy is about more than just making money. The Great Depression caused a lot of secondary effects including World War II. We definitely want to avoid situations like that.

EDIT: All complex decisions involve trade-offs. Right now, there's at least a few dozen more likely ways that people will die other than COVID-19. Heart disease, cancer, car accidents, even seasonal flu currently has a higher death count. You cannot lock down the economy for months on end, ratchet up unemployment to 30%+, and continue to feed people and keep their housing and shelter paid for. People's lives and livelihoods depend on the economy staying functional and healthy. It's not trivial. You have to find some way of moving forward without locking down all 320 million people. Maybe you look at areas of outbreak and you quarantine those areas on a piecewise basis. You ramp up testing, you use masks in public, you do something pro-active to keep the economy going. You provide assistance to those that are at high risk, but you let low risk individuals get back to work and keep the economy moving. The food you eat. The healthcare services you depend on. The military. The semi-truck drivers delivering products and services. The aircraft to transport products and people. All of that depends on the economy working.

Kindly keep the nasty comments about trying to dissuade me from discussing these important topics to yourself.

⬐ wbronitsky

This argument is not worth responding to. You are arguing that our economy should be protected before people are protected. It is disgusting, and I'm tired of rehashing the same disgusting crap over and over.

If you really think that the economic effects outweigh the loss of life this virus can and will cause, all I can do is be glad that all you have is your ability to express your opinion, not the ability to do anything about it. Thank god for that.

Finally, and yes I'm quoting myself here "If you do not have another solution that keeps people alive, kindly be quiet; you have nothing important to say."

> Kindly keep the nasty comments about trying to dissuade me from discussing these important topics to yourself.

This is absurd; you're responding to me. And this isn't a discussion, these are opinions, with no facts to back them up. I simply find these opinions disgusting, as they do not prioritize keeping people healthy and alive.

⬐ z3t4

You also have to take into account what might happen if millions of people loose their shit. People that have nothing to loose are dangerous. Never underestimate stupid people in large groups.

⬐ chrisco255

We lose 30K+ people a year to car accidents, but we keep the roads and cars moving, because we accept that the collapse of those systems would cause more hardship and suffering and death than the systems themselves. We know lung cancer kills a lot of people, as well as liver disease, but we continue to allow for alcohol and cigarettes to be sold, because we know that the pain and suffering of enforcing the laws against those things is more expensive than the diseases themselves. We make all kinds of trade-offs in society. I'm arguing for: protecting the vulnerable and supporting them financially through the crisis but enabling the large bulk of our 20-50 year old workforce to keep the lights on by going back to work and engaging in commerce. That can involve all sorts of compromises with regards to hygiene, but it has to happen. We have tons of debt as a country, there are real systemic risks to continuing like this indefinitely.

⬐ wbronitsky

Again this is drivel. It completely ignores context, cherry picks examples, and again has no data on the current crisis. We could be sending these 20-50 year olds to die, but what do you care? WE NEED TO WORK AND THERE IS NO OTHER SOLUTION, according to you.

These arguments continue to get more disgusting.

⬐ hbharadwaj

Forgetting the overload of medical infrastructure for a bit, here are some of the myriad of issues that this leads to:

1. There are 20-50 year olds with pre-existing conditions such as asthma who are at higher risk. For example, a colleague on my team has asthma. Another colleague on my team has a husband who has asthma. As a Manager, I can't ask either of them to come into work.

2. What about 20-50 year olds who come in contact with 50+ year old or live together with them? They may be at low risk, but they will definitely spread the virus around more

It becomes quite complicated dealing with these things on a case by case basis.

⬐ None

None

⬐ oarabbus_

At low risk of dying.

Not low risk of getting hospitalized and having permanent or long-lasting lung damaged. Do you want compromised breathing for the next 5 years?

⬐ misun78

No idea why you're getting downvoted, this comment is spot on.

⬐ gregcrv

"nearly 40 percent of patients sick enough to be hospitalized were age 20 to 54"

So yes, they are low risk because they get priority in the hospitals. But when the hospital is full, what will happen to them?

https://www.nytimes.com/2020/03/18/health/coronavirus-young-...

⬐ misun78

Hospitalization does not imply high risk. That article also has an unnecessarily wide range to make the data meaningless. Why are 20 year olds and 54 year olds bucketed in the same category?

For more accurate data, 0 deaths have occurred in Italy for those under 30. Under 40, the few (9) are due to severe pre-existing conditions. Median age for fatality is 80 years old.

The exponential curve not only applies for rate of infection but seems to be holding true for age as well.

Edit: Source for Italy data here - https://www.epicentro.iss.it/coronavirus/bollettino/Infograf...

⬐ dajohnson89

could you please share a source? I dont think your comment deserves to be downvoted like it is, but a source on the data you mention would be very helpful.

⬐ _delirium

This article from yesterday has a decent summary of case fatality rates by age in various countries: https://www.vox.com/2020/3/23/21190033/coronavirus-covid-19-...

⬐ misun78

https://www.epicentro.iss.it/coronavirus/bollettino/Infograf...

⬐ wolco

He is right on 0 deaths in Italy, Spain has one but 15% hospitalized rate.

https://www.google.com/amp/s/www.vox.com/platform/amp/2020/3...

⬐ toby

I don't know why you're getting downvoted on this, the range they choose is super weird.

The actual report says that people under 19 comprise 2% of hospitalizations -- I doubt it suddenly jumps to 38% for the next 5 years. It also says there are no known fatalities of people under 19.

⬐ omarhaneef

Not sure why you are being downvoted rather than argued with.

Here is part of the problem: hospitalization and ICU don't necessarily mean the patient will die as long as we have the resources to hospitalize, intubate and medicate the patient.

Once we are out of respirators and the like, then the death rate with these patients will spike.

In Italy, we are seeing younger patients face graver conditions over time as the medical system gets overrun. [citation needed if someone help me dig one up? I can't remember where I read this]

this could be for a number of reasons though:

1. younger people feel invulnerable and go out more

2. underlying conditions in these people x a large population

3. overwhelmed hospitals

Likely, some combination of the above.

⬐ misun78

These are all unsubstantiated claims that I am pushing back on against the mainstream narrative. Can you cite data for:

1. "Seeing younger patients facing graver conditions" - are we seeing excess mortality rates amongst the younger population in Italy as we speak (compared to say this time last year)?

⬐ omarhaneef

I don't know man, seems like you could do a simple google search and find a ton of references:

https://www.independent.co.uk/news/world/europe/coronavirus-...

https://www.nbcnews.com/health/health-news/not-just-older-pe...

The virus grows fast so the question is what % of people of a particular category who have it will need an ICU/hospital to prevent their death.

⬐ slg

> we needed to shut down the city, and everyone else arguing it would destroy small businesses

The problem is that they are right with this. Shutting down the city will probably destroy small businesses. Those same people also can't do much to help small businesses. It is understandable that they don't want to sentence these businesses to death when they are powerless to save them. This is why the relative inaction by the federal government is such a problem here. They are the only entity that has the power to stop the wide spread of the virus and absorb the economic repercussions of the shutdown.

⬐ davidw

What happened in Italy is that they delayed... and then ended up shutting down everything anyway - just with a lot more infected people and deaths, and the exact same economic hardships.

⬐ birdyrooster

Probably worse economic hardship with the added strain on the labor force.

⬐ yiyus

Staying open is not a panacea for small businesses. Nobody is travelling, nobody is spending. My parents have a small shop (in Spain) and they had to close before the lockdown started because they were not selling anything. And, by that time, things were much better that they are now around here.

⬐ slg

You are certainly right, but it is a question of blame. If the government shuts down your business and it never recovers you will likely blame the government. If the government lets you stay open and your business still fails you will likely blame the virus.

EDIT: This is being downvoted, so let me make a clarification that I am explaining the government's potential reasoning but I am not excusing or agreeing with it.

⬐ mistermann

It seems to me that the root cause in all these things is a lack of appreciation for the manner in which people think. And further, that we (both our leaders as well as people in general) assign practically zero importance to this aspect of the problem. It seems to me that we almost don't even recognize that it's there (and here one must be careful: yes, if someone points this phenomenon out, we can all see it then - but change the topic of discussion to something else, and watch that knowledge seemingly vanish).

In this case, I propose that a better definition of the problem is: people disagree on which variable to optimize.

But neurotypicals don't think in terms of "optimizing a variable" (precise, logical thinking), for a given set of variables. Rather, they think in terms of what is "the right thing to do" (fuzzy, heuristic-based thinking), in a given situation.

System 1 vs System 2: https://en.wikipedia.org/wiki/Thinking,_Fast_and_Slow#Two_sy...

Everyone "thinks" (see: recursion) they think in System 2 (conscious, logical), because this is what we perceive, in infinitely high resolution - it seems like what we think and believe is purely the result of disciplined, rational thought, but it is not. Not even close. And it's not just those who are less intellectually capable than us....it's all of us.

Now, it is obvious of course that the degree to which each individual person suffers from this will vary significantly. If we had a means of measuring this, this would give us a metric of the variance of this phenomenon between people at the personal population level. I would call this the relative variance of X.

But there's another metric that is far less obvious: the ~absolute variance - this metric compares variance not between the peoples of Earth, but between them and a purely rational, emotion-free actor.

It seems to me that the second metric would be an extremely interesting thing to know, and perhaps extremely useful. But alas, we have no data source. I wonder though: might there be a way to come up with an estimate that is plausibly accurate?

⬐ bad_user

If the government doesn't shut down businesses, we get hundreds of thousands of unnecessary deaths in addition to the economic crisis, which is here anyway.

Spain's hospitals are collapsing, sick people are now laid on the ground, they are improvising by making new beds in expo halls, etc. It's not just Italy now, we're seeing how bad it gets and it only takes another week or two for the rest of the world.

⬐ Enginerrrd

In my county, during the 1918 flu, they just banned public meetings and enacted a mandatory mask law that said you had to wear a cotton mask if you went out in public. It worked really well. The town that enacted the mask law the earliest and pushed it the hardest did the best through the first 2 waves of infection. It worked so well, that they decided it was an over reaction and repealed the mask laws and then they got absolutely hammered in the third wave.

I don't see why we couldn't do a mandatory social distancing & mask law (even an improvised one) and let people otherwise go about their business. It would help lessen the impact to businesses, and arguably could result in significant reduction in the transmission rate.

⬐ llampx

In the Czech Republic there is such a mask law. One must wear something over the nose and mouth. As to why other countries don't enact the same, I don't know.

⬐ 83457

They didn't know about germs and hand washing back then so not in your recommendations? Also, how many ended up dying in your county?

⬐ rush86999

it's hard to do social distancing when we are social people or we might bump into someone despite trying. Also only N95 masks are effective to prevent transmission. Regular masks don't really work and provide false sense of safety.

⬐ Enginerrrd

This comment is deeply flawed, if not blatantly false, please read the following before you consider spreading this information again:

First off, social distancing is a risk mitigation strategy for droplet transmission. The idea is to provide sufficient distance between people and a cough or sneeze that a large fraction of the droplets settle before they could end up in someone's eyes/mouth/nose/next inhaled breath. Briefly invading someone's 2-3m bubble while accidentally bumping into them or walking past them really carries very little risk of exposure. It's more relevant to having a conversation with someone, particularly when indoors.

Whether or not aerosols play a major role in transmission remains to be seen, but we know that the virus can survive in aerosols for hours, and aerosols can remain suspended in the air for a very long time. (That's where N95's may become more relevant, but pathogens that have a dominant aerosol transmission are rare. Things like TB and measles behave that way. SARS-CoV-2 would probably have a high R0 if it were dominantly transmitted this way.)

Now, the statement "only N95 masks are effective to prevent transmission" is just false in several different ways:

First, when worn by healthcare workers, there is no significant difference between surgical masks and N95 respirators in preventing respiratory infections.[1][2] To quote the meta-analysis study[1]:

>"We identified 6 clinical studies (3 RCTs, 1 cohort study and 2 case–control studies) and 23 surrogate exposure studies. In the meta-analysis of the clinical studies, we found no significant difference between N95 respirators and surgical masks in associated risk of (a) laboratory-confirmed respiratory infection (RCTs: odds ratio [OR] 0.89, 95% confidence interval [CI] 0.64–1.24; cohort study: OR 0.43, 95% CI 0.03–6.41; case–control studies: OR 0.91, 95% CI 0.25–3.36); (b) influenza-like illness (RCTs: OR 0.51, 95% CI 0.19–1.41); or (c) reported workplace absenteeism (RCT: OR 0.92, 95% CI 0.57–1.50). In the surrogate exposure studies, N95 respirators were associated with less filter penetration, less face-seal leakage and less total inward leakage under laboratory experimental conditions, compared with surgical masks."

Next, let's look specifically at surgical masks when worn by the public in the case of SARS-CoV-1 in the following study[3]:

>We also used this investigation to quantify the impact of behaviors (i.e., mask wearing, handwashing) that were promoted to reduce the risk for SARS. Wearing masks outside the home in a reference period corresponding to the 2 weeks before symptom onset for cases was significantly protective against clinical SARS. Supporting the validity of this finding, there was a dose-response effect: by multivariable analysis, persons who always wore masks had a 70% lower risk of being diagnosed with clinical SARS compared with those who never wore masks, and persons with intermittent mask use had a 60% lower risk. Many persons who wore masks in the community did not use N-95 or similar highly efficient filtration devices, which have been recommended for use in the hospital setting.

And finally, the above doesn't even address the fact that mask protections work BOTH WAYS. It has also been shown[4] that masks when worn by infected individuals help prevent the dissemination of infectious droplets and aerosols, and reduces the rate of viral shedding. To quote that study, specifically on placing surgical masks on the infected: >"Overall, masks produced a 3.4 fold (95% CI 1.8 to 6.3) reduction in viral aerosol shedding."

Finally, there's evidence that even homemade improvised masks work surprisingly well! They perform only marginally worse than surgical masks in particle filtration tests.[5][6] (Remember how surgical masks, which perform worse than N95's in those same type of tests, showed no significant difference in their ability to prevent illness?) To quote the conclusion of study[6]:

>"Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence, personal respirators providing most protection. Masks worn by patients may not offer as great a degree of protection against aerosol transmission."

TL;DR In short, if everyone in public wore masks, it would not only be definitively protective for the wearer, but for those around them as well.

[1](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868605/)

[2](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5779801/)

[3](https://wwwnc.cdc.gov/eid/article/10/2/03-0730_article)

[4](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3591312/)

[5](https://www.researchgate.net/publication/258525804_Testing_t...)

[6](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/)

⬐ bigmanwalter

We aren't doing it because they didn't order enough masks back in December when they could have.

⬐ Sawamara

The problem is that they are not right. When there is an ongoing epidemic, it is not about "oh, lets reopen quickly."

Reopening quickly NOW would mean: - The collapse of the hospital systems of ANY country currently on earth (save a few that are actually working for the people, not to make profit) - The endangering of many, if not all medical professionals - A huge reduction of workforce realistically, because there will be many people sick for multiple weaks, prepare to lose 5-10 percent of your FULL workforce if the hospitals are overloaded.

So if the shutdown is not implemented, and not followed through, the economy will STILL collapse, and the consequences will be 3-4 times more deadly to the whole population.

The only upside to the global epidemic is that finally the neoliberal haegemony is ending, and libertarian dreamers who were not facing tough situations before can actually see where their favorite policies lead in the actual real world.

And we all will see it, because the inertia in the system will keep forcing politicians all over the world to ignore basic rules of society in favor of chasing a dream (some GDP growth preservation).

We can all see it clearly if we take the time to think it through. You have a bellyache. You want to eat cake. You can either not eat it, or you can eat it, vomit it out, go to the hospital, and still not feel well. Oh, and the hospitals are overloaded with COVID-patients.

⬐ lifeformed

Maybe this is a naive question, but... why can't we temporarily just stop the whole chain of debt instead of forcing individuals and small businesses to bear the brunt of losses? Right now the issue is that if we're not working, we're not making money, and we can't pay for rent and debts. But is the only solution to find a way for the government to give the people money and let the businesses collapse? Why can't we put the burden further up the chain? Doesn't it all end up at the banks? I pay my landlord rent, my landlord pays mortgage on the property to the bank. Can we pause rent and mortgages and debts for a few months? Sure, there would be big damage done to the economy still, but why do we have to let the damage happen at the individual level? I'm sure there's some simple explanation, but I don't understand why.

⬐ specialist

By default or by design, debt forgiveness will occur.

David Graeber's book Debt: The First 5000 Years details the cyclic history of such things.

Some of the more savvy Haves, like Mitt Romney, recognize the current threat to the status quo and have made their opening bids on negotiating an armistice with the Have-Nots.

Others, on both sides, are less willing to haggle.

⬐ bigmanwalter

You're exactly right. But our leaders are afraid of everyone realizing just how easy it would be to end our debt slavery.

The United States is run by a landlord and all his power comes from workers servicing his debts.

⬐ brutal_boi

Very naively here (and prob wrong in many aspects) but I expect those you are talking about to have leverage on these decisions unlike us (the lowly pleb); I don't expect a bank ceo choosing to take that giantic hit of a burden when it can just be pushed globally on the society. You could even argue that if a bank is able to do thay, they could do it anyday and not require a pandemic event.

Still, a stronger argument is that a bank is a business overall. They live out of debt. That kind of hit could also kill the bank I believe.

⬐ jb775

Great point, but it would probably send us into the dark ages when people refuse to re-start the chain of debt. People are def afraid of this possibility, hence the gun shop lines wrapped around the block. Debt: The first 5000 years is a great book that explains details of what would likely happen.

⬐ crispyambulance

> Maybe this is a naive question, but... why can't we temporarily just stop the whole chain of debt instead of forcing individuals and small businesses to bear the brunt of losses?

It's not a naive question. Unfortunately I don't think the answer is going to be palatable.

⬐ massysett

The bank sells the mortgage to Fannie Mae. Fannie puts it into a mortgage-backed security. Your life insurance company or pension plan buys that mortgage-backed security. So it comes right back to you. There’s just no good way to compensate for weeks or months of economic activity that just doesn’t happen.

⬐ viklove

Basically our whole economy is based off of BS IOU's and the moment there is any problem in the world the whole system comes crashing down around us. Decades of economists and investors building layers and layers of obfuscated financial abstractions so they can get rich finally has its consequences.

I guess it's been a while since we've eaten the rich. It was a long time coming.

⬐ 0xff00ffee

This feels like a giant game of "I can't wait to say 'I told you so!'" by many different factions. The HeadInTheSand GOP, the Apocalyptic Left, the panicked middle (/r/coronavirus). Everyone except health professionals.

Competitive Schadenfreude.

⬐ emilsedgh

While we are in the middle of an apocalypse, you're name calling the people who predicted it.

I sincerely hope that one of the side effects of this crisis would be more acceptance towards science.

⬐ 0xff00ffee

I name-called the "health professionals"? Help me out: what do they like to be called?

⬐ RandallBrown

I have so many friends that seem to be just reveling in the pandemic. If someone posts a picture of themselves anywhere but on their couch they comment "STAY HOME!" and they do nothing but post memes about how people aren't staying inside or how everyone needs to wash their hands. Any good news is met with extreme skepticism but any bad news is treated as absolute truth.

It's literally all they do anymore and I just can't imagine living my life so negatively.

⬐ yiyus

It gets worse. People post memes when reading about numbers. Then those numbers turn into names of famous people, and finally names of people you directly know, and memes stop being funny.

⬐ starik36

> the panicked middle (/r/coronavirus)

The Panicked Middle leans heavily towards the Apocalyptic Left.

⬐ TLightful

That's why there are right wing governments in the US, the UK and many other countries.

Stay off the political drugs. They're not good for you.

⬐ SuperFerret

Health professionals are generally lefties. Same with scientists.

⬐ SuperFerret

Enlightened centrist

⬐ skrebbel

Loving the term "the Apocalyptic Left"

⬐ nocorpwelfare

"Health professionals" are just another interest group filled with leftist fools, total Dunning Kruger effect going in most quarters there. In my Biostats courses at UNC I ran into the same personality type over and over and over again. I get that they're well-intentioned, but they're too proud to know what they don't know.

We'll get through this, regardless. Plenty of brilliant minds coming to the fore right now.

⬐ jansan

We'll get through this, regardless. Plenty of brilliant minds coming to the fore right now.

When the going gets though, the tough get going. This is really what you will see in the near future.

⬐ sixo

It would be better if the parties that were proved wrong could show some generosity to admit they were wrong, apologize and give some indication that, given the magnitude of this event, they would be more willing to swallow their pride and listen to others in the future.

Unfortunately _that_ seems to be off the table. So what if the counterparty wants to taunt them a little? Maybe it's rude but at least they're not killing people.

I don't think any group in this country is mature enough not to operate with pride at all, but it's amazing how far some people will go to avoid admitting fault.

⬐ DanSmooth

Perhaps also of interest, his recent AMA on Reddit: https://www.reddit.com/r/Coronavirus/comments/fksnbf/im_bill...

⬐ ryndbfsrw

I try to imagine the counter-scenario where leaders had done the correct thing but because they did the right thing and a spread never occurred we collectively boot them out of office because nothing bad happened and criticize them for 'overreacting' when that is exactly what is needed for a pandemic.

I am sympathetic to why nothing changed and no one listened. good risk management shows up as nothing bad happening. Heroes who avert disaster don’t get statues.

⬐ siwatanejo

This is why good security professionals are never promoted: if they do their job well, nobody notices.

⬐ nojvek

Or may be they do because they say “look competitor X just got pwned and is bleeding customers which are coming to us”.

⬐ mistermann

Very good point.

Most people do not include counter-factuals in their thought process. I would go further and propose that not only do most people not even know what counter-factuals are, but many of them would be extremely psychologically resistant to the very idea.

A similar example of this is: go into a forum, find someone who is predicting the future, point out to them that they are predicting the future, and observe the result. Now do this 100 or 1000 times and keep track of your results.

"But this is just people being stupid!"

I disagree. Yes, it is indeed people being stupid....but is it "just" that?

⬐ dfxm12

We saw what happened in China and then Italy. Nothing bad happening would not have gone unnoticed.

Plus, the idea that our elected officials let people die in some sort of racket to prove their use is more reason to boot them out of office than a peaceful term.

⬐ jodrellblank

You are sympathetic to the "leaders" putting their careers ahead of people's lives? .. why are you?

> we collectively boot them out of office

This unfair treatment happening to a few dozen people at most, doesn't seem to be enough to balance the scales here.

⬐ nocorpwelfare

Look, the US and everywhere is more interested in financializing everything, leveraging and doing all kinds of other stupid shit in order to make money without actually producing anything. So this is what you get.

Want strong civil defense? Look at Switzerland.

⬐ tome

That scenario would only come true if every leader did the correct thing. In the more likely scenario where some did and some didn't, the ones who did would say "It might seem at first sight that we overreacted, but look at country X. They didn't act and all their citizens are dying and the economy crumbling."

⬐ jimbob45

Would things have been different if it had started in a country other than China? Politics aside, starting in the most populous and most trafficked country on Earth seems like the worst-case scenario.

⬐ beager

Population density is a factor to be sure, but the government response was a bigger factor in failing to contain it in my opinion.

The CCP’s culture of fear and retribution pushed municipal officials to suppress reports of a novel outbreak, and pushed authorities to retaliate against medical professionals sounding the alarm.

A culture of transparency and non-retribution may have enabled China to contain this, and could have provided earlier warnings to the world to prepare for an epidemic or pandemic that might not have even happened.

⬐ bcrosby95

A handful of countries were able to prevent an epidemic in their own country because they responded quickly. The vast majority of them ignored the virus and claimed it wouldn't come here, and changed their tune only when it was too late.

China gave a perfectly fine head start as evidenced by countries that were able to contain it. Everyone else just wasted the head start, and I see no evidence that they wouldn't have wasted it even if China gave them a longer one.

⬐ misun78

Which countries are you referring to?

⬐ wpasc

The first US case was diagnosed on Jan 19 2020. The US-China border was closed on Feb 2. Screening procedures followed later on. It is up for debate whether or not screening procedures would have started earlier if the border had closed earlier. BUT, to say there is no evidence at all that a longer head start would have helped countries is a very dubious claim.

⬐ KaoruAoiShiho

I guess some people actually believe this. The new orientalism?

⬐ 49531

Yea, unfortunately that seems to be the case. While local level officials in Wuhan punished some early whistleblowers for posting publicly about the virus the Chinese Supreme Peoples Court said they should not have been punished.

I think China has shown a lot of transparency and has put a ton of resources towards containment.

⬐ iforgotpassword

I agree with your initial reasoning, although given the long incubation period that was initially unknown I still see a high chance this would have spread either way. But

> and could have provided earlier warnings to the world to prepare for an epidemic or pandemic that might not have even happened.

Not in a thousand years. The west was sitting on their hands for almost two months, busy armchair-commenting on the CCP's failings, preparing half-heartedly at best, taking no proactive measures whatsoever. I'm utterly disappointed with my government and don't see how this would have turned out any different for us had we had twice as much time to prepare, or had this originated in a western country.

⬐ mratsim

And also the most probable, especially given the diet in some of the regions. That said, some countries in Africa also eat bats and pangolin and Ebola came.

⬐ WorldMaker

Diet is most probably a giant red herring in all this.

There's just no "right diet" if you want to avoid disease mutation. Mad Cow Disease, Salmonella, Avian Flu, Swine Flu, all of those and more have (and continue to) cross-infect our species from standard western diets. Several major western religions ban pork for "uncleanliness"/prone-to-disease, for what were once very good historical reasons.

Even if this virus did have something to do with diet, the only rational response is to cut way back on all meat, not just "weird" meat to a Western view, because it isn't just "rodents" or "ugly animals" that mutate these sorts of virus, because we've seen it with pigs, chickens, cows, etc. Probably no one wants mandatory veganism, but that's nearly the only "safe" option if you want to demand we track regional diets. (Even then you get things like salmonella cross-infections from fertilizers used in vegetable farming. There's no 100% safe diet. Life, uh, finds a way.)

⬐ atomi

We regularly euthanize diseased pigs and chickens because of viral outbreaks - sometimes millions at a time. We would do well to try not eating so much animal protein.

⬐ brianwawok

I have no idea how to figure this out. But my thought process is:

What % of people in a given region in a given month travel outside:

a) Their city

b) Their state/providence

c) Their country?

and then compare it to other countries. I suspect there are many places it could have started with way more international travel.. which would have made the first wave hit more places at once.

⬐ nocorpwelfare

There is a large contingent of itinerant fools who travel the world endlessly in search of identity yet never locate it.

⬐ save_ferris

We'll never know, but it's worth pointing out that the slow and disorganized response by many western countries like the US and UK seemed to be less influenced by where the disease originated and more heavily influenced by a localized desire to pretend everything was normal.

I have a hard time seeing a different outcome if a virus of similar potency came out of Africa or somewhere else, based solely on how poorly leaders from around the world have responded to it.

⬐ api

Things like responding to a pandemic are precisely where authoritarian regimes excel.

Authoritarian structures generally excel when you need a lot of people to do a lot of the same thing: responding to disasters in simple but effective ways, high volume manufacturing, grunt and infantry level military operations, and large infrastructure projects.

These are the areas where China leads the world. With the possible exception of the military, America and other Western democracies are downright horrible at these things. We can't build infrastructure, have lost much of our high volume manufacturing, and react to disasters with delay and bickering and population non-compliance.

Where they don't excel is creativity, invention, innovation, culture creation, and maximizing individual well being in peacetime. They're also more politically brittle because there is no graceful mechanism for non-violent political change.

⬐ cvlasdkv

I firmly believe your comment is conflating China's competence with its political structure. There are definite benefits when it comes to large-scale planning when your country is already familiar with state-planning and infringement on "freedoms". That being said, a look at a country like Brazil would show you that being authoritarian is not enough.

In the same vein that there are democratic countries who are handling COVID 19 much, much, better than the West. Not to mention those same countries give us great "innovation (e.g. technology), culture creation (e.g. Parasite), etc.". The Western democracies should not escape blame because they are "democracies".

⬐ save_ferris

It's also much easier for authoritarian regimes to give off such impressions when they can lock up and execute whistle-blowers and critics without with access to any semblance of a just legal system.

⬐ simonh

Ive seen a lot of comments like this recently and I think they're really a bit lazy and simplistic. China made some grave errors as others have pointed out, and those are directly attributable to their authoritarian system. Also democracies and be highly organised and co-ordinated. Look at the speed and efficiency with which South Korea and Germany have responded. It's as much about culture as politics.

Also on high volume manufacturing, China's success at this has nothing whatever to do with authoritarianism. None of the big manufacturing concerns in China are state run, they're all private companies build using private capital. Their success is a result of the government getting out of their way.

⬐ PeterisP

The handling of Covid-19 in Iran is a great counterexample.

⬐ Ididntdothis

Only when they have made up their mind to respond. It took the soviets a very long time to respond to Chernobyl. The first instinct of authoritarians is to pretend problems don’t exist.

⬐ kiba

South Korea and Taiwan did all right and they're democracies.

⬐ iron0013

Chinese style technocratic authoritarianism might excel in the face of pandemic, but one need look no farther than Brazil to see that old-fashioned grievance-based reactionary authoritarianism falls flat on its face when it needs to deal with any problem that can’t be swept under the rug by blaming it on a group of “Others”

⬐ nocorpwelfare

The US is doing just fine and there is no need for further authoritarian measures right now. We'll do what me must when we must.

⬐ atomi

You might want to check out the TV miniseries Chernobyl.

⬐ Spellman

While once they make up their minds to act they can be extraordinarily effective, getting to that point can be a mess.

For a while they suppressed information about what was going on in the region, suppressed information to the outside world about the virus, and generally said "Everything is fine" delaying their response.

Now, to their credit, once they committed they did an excellent job. And the population has complied in amazing fashion. But the slow-moving party has a weakness that it won't broadcast when things are starting to go wrong until they can't ignore it any longer.

You can also imagine what would have happened if they continued to lock up critics for even longer.

Enlightened authoritarians only work if they are, well, enlightened. Once corruption seeps in those same levers of power can be exploited for personal and Party gain.

⬐ jliptzin

It’s because we have really been in the midst of a stupidity epidemic for at least the last 5 years and our debt has finally come due.

⬐ mcrad

This is exactly right. The evidence is not an any academic journal but in the way power and money led to the demise of major political parties and other institutions. The trend led to a shoddy papering over of the last financial crisis, which led to even more "creative" ways to blow bubbles, and further deteriorating checks and balances in both public and private sectors. Does the scientific community know about this? More importantly do they care? Granted, the virus is a serious matter. However the response is basically a different problem. Those in power know the financial system is strained beyond repair, and have a very strong incentive to use HC Healthcare Crisis to avert the blame and prepare new world order. Something like that.

⬐ chapium

Much longer than that.

⬐ Enginerrrd

For only the last 5 years?! We started approaching our current level of polarization and infighting over wedge issues during the 90's, and have steadily gotten worse. Both sides are hopelessly deadlocked and so convinced they're right as to completely disparage and dehumanize half of the population. They're more interested in fighting the other side than they are moving forward in any way if it involves giving the other side a victory, no matter how small. If that's not the stupidity that got us into this mess, I don't know what is.

⬐ throwaway894345

By my estimation, most elite media, academia, and other epistemological institutions retained a strong sense of professional integrity prior to ~2012. They certainly had their biases, but they took some care to veil them. This change felt pretty distinct and abrupt to me; before the sort of overt partisanship was widespread among the general population, but these elite institutions were generally seen as above the fray. Afterward, we saw a steep trend toward tabloidism that climaxed early last year with the Covington Catholic affair (for the unfamiliar, the media doctored a video of some students to make them appear to be frothing racists to the effect that they were mobbed online and received threats of death and violence even from celebrities) but which has remained in a lesser but still heightened state ever since.

⬐ dustingetz

"Sufficiently Powerful Optimization Of Any Known Target Destroys All Value"

From the Moral Mazes blog series featured on HN a couple months ago https://thezvi.wordpress.com/2019/12/31/does-big-business-ha... ; the first segment is https://thezvi.wordpress.com/2019/12/28/moloch-hasnt-won/

⬐ throwaway894345

I really hope we (the US) conducts a thorough and credible investigation as to who is responsible for this failure to prepare for this crisis. I have minimal faith in government or regulatory agencies, but I thought the CDC was one of the few government agencies that had its shit together. Apparently they couldn't even be bothered to keep a reasonably stocked reserve of masks and ventilators--things that we knew we would need in the event of a respiratory disease outbreak which we were looking pretty probable following SARS and MURS. Never mind planning to secure and ramp up critical supply chains. I'm sure there's lots of blame to be laid at the feet of congress and various administrations, but these things seem to be squarely in the purview of the CDC and certainly aren't line items on the congressional appropriations bill.

I want criminal charges pressed against bureaucrats and politicians tarred and feathered not so much because I'm pissed that their negligence has killed / will kill thousands but so that future politicians and agency heads will take this shit seriously in the future. If there aren't sufficient legal avenues for holding politicians and bureaucrats accountable, then we need to create some.

⬐ kiba

I really hope we (the US) conducts a thorough and credible investigation as to who is responsible for this failure to prepare for this crisis.

I don't see how blaming x and y will fix anything but boot out the current bureaucrats. The next time a pandemic happens, the guys who remembered anything in living memory are already dead or retired.

Worse, punishing people when they don't understand or making honest mistakes are going to lead to hiding of their mistakes or incentive not to understand anything.

but I thought the CDC was one of the few government agencies that had its shit together. Apparently they couldn't even be bothered to keep a reasonably stocked reserve of masks and ventilators

It's hard to keep a reserve of masks and ventilators when the higher ups don't think your mission is particularly important and you don't have a budget. Ventilators and masks costs money to store, maintain, and test.

The better solution is to prioritize pandemic preparation and war game pandemic scenario, and conduct an honest investigation to prepare for the future, rather than punish people.

⬐ throwaway894345

We have accountability for every other executive. Why do top brass at CDC get to plead ignorance?

Maybe to your point the CDC or Congress really is just one guy working out of his Atlanta garage and it is too much to ask of him to maintain a stockpile of basic supplies for the most likely disaster scenario (you know, those respiratory disease outbreaks that we've seen 3 of in the last 2 decades). If this is what the investigation finds and this guy really did everything he could with the budget he had, then let's name and shame the politicians who gave him that budget.

Like I previously mentioned, I don't doubt that congress didn't give the CDC a stellar budget, but I have a hard time believing that they spent their resources on better things than masks and ventilators (no, not based on hindsight, but based on the pattern of respiratory disease outbreaks) and that they couldn't even afford to plan to secure supply chains. That's like one analyst's job for several months.

But again, maybe I'm wrong and the fault lies squarely with Congress or one or several administrations--those politicians still deserve to be tarred and feathered (again, accountability is a real thing). In any case, we won't know without an investigation.

> conduct an honest investigation to prepare for the future, rather than punish people.

Nope. "Accountability" is preparing for the future. Without it those in charge will just ignore those best laid plans because they're too expensive and there's no cost to ignoring them. If you drive drunk and kill someone, you go to jail. If you are in charge of a federal agency and you don't do your basic due diligence and your glaring fuck-up kills thousands of people, we shouldn't laugh it off.

⬐ chapium

Trump is already blaming china for not containing this, even though the us has equal responsibility to contain the virus within our own borders. Not to mention the measures taken by china to flatten the curve were extraordinary.

⬐ dfxm12

There's plenty of blame to go around, not the least of which falls on the president [0]. His party mates in congress have shown to be unwilling to hold him accountable. You have some power to hold them accountable come November.

0 - https://www.theguardian.com/us-news/2020/mar/24/trump-cuts-u...

⬐ RyanShook

Really thankful that Bill Gates is focusing his attention on coronavirus at this time. I think he will likely be called one of the many heroes in this epidemic.

⬐ tbergeron

Seems he was ready after all. Look up Event201 and ID2020.

⬐ melling

I found this:

http://www.centerforhealthsecurity.org/event201/

⬐ cbhl

It appears they updated that page to explicitly state that the tabletop exercise was not meant to be a prediction, but simply to highlight challenges in responding in a pandemic.

⬐ jjoonathan

Well, yes, but the general prediction is trivial. There's going to be another bad virus after this one, too!

⬐ melling

Here’s an exercise:

There’s an epidemic in the China with a population of 1.3 billion, the second largest economy. They lock down Wuhan on Jan 23rd to try and contain it from spreading to the rest of China.

On Jan 30th with 7818 infected, the WHO declares Global Health Emergency. It’s a now threat beyond China.

What do you do?

Things to consider:

- There are 100,000 global flights a day.

- China is rushing to build 2 hospitals in 10 days

- It appears to be highly contagious

⬐ user_50123890

USA banned flights from/to China. Italy banned flights from/to China. (both decisions caused an outcry about "racism" at the time, btw) Other countries kept the flights going. USA and Italy are now the countries hit hardest despite these restrictions, because the economy is global.

Either all countries must react properly, or a single country's actions won't do anything. Good luck with that.

⬐ melling

The horse left the barn and you closed the doors.

China had already locked the doors within their country to try and contain it. Anyone who isn’t a Chinese National can fly in and out of China for the United States.

We didn’t ban flights, we banned Chinese citizens.

Are you sure, you aren’t lulling yourself into a false sense of security?

⬐ MagnumOpus

Interestingly, the more severe response of "check or cancel all flights to China" would not have worked, because by January 21th, the virus started community transmission in Germany and Italy.

But stocking up the mask and respirator and PPE reserve immediately would not have gone amiss, nor would fever checks at airports, public buildings etc.

⬐ Erikun

I feel like the problem with stocking up on material is that it would have to be done before the outbreak even began in China. By mid january, China was vacuuming the market completely for equipment and from there on it has only gotten worse for any country that didnt have domestic production, as countries who did started banning exports.

⬐ melling

There was also community spread in the United States on Jan 21st. Patient Zero arrived before any lockdown.

https://www.bloomberg.com/news/features/2020-03-09/how-coron...

⬐ zaptheimpaler

The asian countries by and large did better because they don't view every decision through a narrow economic lens. They simply understand that the health of their population is the ground upon which everything else is built.

US/West has been taken over by paperclip maximizers, thats all. The landlords want to maximize paperclips, so no rent relief for small businesses. The politicians see this and decide shutting down would be catastrophic, instead of questioning the premise.

Like it is literally inconceivable to me how retarded modern capitalism is. You need a 5-6 week shutdown on businesses, so force rent to be waived for that period. Thats most of the fixed cost, and the employees being on leavetakes care of the variable cost. The businesses don't go bankrupt, everyone just takes a 6 week vacation and comes back like nothing happened. You need ICUs/equipment - take over hotels and make it happen. Instead, they are worried about getting congress approval to pass a bill to pay the hotel owners leasing costs during a global emergency. In the face of a million deaths, the paperclip maximizers can only see all the lost paperclips.

⬐ tehjoker

Bill Gates, the giving pledge guy, is somehow richer than before he took the pledge. His organization is also mysteriously involved in encouraging the women of developing nations to get IUDs under a Malthusian theory that mysteriously benefits the people of rich nations over poor nations.

This guy may be talking to health experts, but he's not someone we should be taking advice from. He represents the right wing of international development aid.

https://www.dailywire.com/news/whos-racists-bill-gates-spend...

⬐ pinkfoot

> get IUDs under a Malthusian theory

3 new people per second.

Out of curiosity, which developing nation problems get easier with more people?

Mankind's time of easy answers is behind us.

⬐ DarkCoder

i highly doubt that. its all about microchip implemenation

⬐ glofish

yeah, he was not ready even after telling us about how we are not ready

⬐ melling

The warning was for us...5 years ago.

⬐ 3fe9a03ccd14ca5

Warnings are cheap and easy. Lots of people warning about all kinds of things all of the time.

Where is the technology? Where is the solution? Where is the execution on the warning?

⬐ dangus

We should be expecting our governments to be ready, not a billionaire with a charitable foundation.

I wish my government was as effective and functional as Taiwan or South Korea.

⬐ tathougies

We should follow Taiwan's lead and withdraw from WHO, who lied to the entire world while Taiwan was preparing.

⬐ merpnderp

The warning was for governments. If the US had spare ICU capacity, and a national reserve of PPE and critical care supplies like we had before 2009, we'd be miles better off.

Experts knew it was "all but airborne if not airborne" and that masks were the best way to stop it from day one, but discouraged Americans from buying them as the hospitals would desperately need them far more. So many more people will be infected and die because they didn't have a $.50 mask. And this is all because we didn't spend a tiny pittance getting ready.

⬐ dang

https://news.ycombinator.com/item?id=22575745

⬐ melling

It’s 10 days old and has far fewer comments

By marking it as a duplicate, you just killed this new thread.

⬐ dang

The criterion we use is: did the previous post get significant attention? 87 points and 36 comments is way over that threshold.

When a discussion is particularly good, we sometimes override that. This one seems pretty generic to me, though, especially in light of how many coronavirus threads HN has been seeing. I'm not sure there's even a single comment below that is reacting to more than what's in the title: "outbreak", "not ready", and "Bill Gates".

⬐ nouveaux

I'd argue that this post is more relevant than 10 days ago and should receive an exemption.

10 days ago, the number of cases were small and there was no lock down. Many people did not consider Corvid-19's real impact. Now that most of the country is taking it seriously, it is more top of mind.

10 days ago, Corvid-19 posts were barely considered here on HN. Now many are generating serious discussions.

Please reconsider marking this as a dupe.

⬐ dang

We've also had 10 days worth of massive coronavirus discussion. The issue is the quality (and specificity) of this thread relative to the others.

bill gates saw this coming in 2015 [1] and proposed many solutions so we could better prepare including assembling a medical reserve corps, simulated "germ games", and investments in medical R&D along with increased investment in 3rd world health infrastructure to stop the infections before they spread

also many asian countries were better prepared due to their exposure to mers/sars [2]. so there was a precedent and influential people calling for change

but investing health infrastructure is not the Fed's job, that is congress/government's job - AKA the job of corporations through lobbyists who have no incentive to do any type of preparation, just perpetuate the consumption cycle

the fed is just responding to an economic crisis by trying to bail water out of a sinking boat, but they don't have the power to actually rebuild/fix that boat

[1] https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re...

[2] https://www.ft.com/content/e015e096-6532-11ea-a6cd-df28cc3c6...

⬐ Ididntdothis

“bill gates saw this coming in 2015“

Let’s not make Gates the hero here. Most people working on infectious diseases knew about these problems.

⬐ saiya-jin

Most people in general. Every time ebola started in Africa, there were information campaigns. But as long as you don't touch and it doesn't mutate, nobody cared much for some poor uneducated africans.

Everybody just thought it won't happen during their life/term, like some big asteroid impact. Well, not anymore

⬐ dang

https://news.ycombinator.com/item?id=22575745

⬐ melling

“If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus”

⬐ dbg31415

Why is this flagged as a dupe? It's the only instance that comes up in search for this URL.

⬐ csomar

> So next time, we might not be so lucky. You can have a virus where people feel well enough while they're infectious that they get on a plane or they go to a market. The source of the virus could be a natural epidemic like Ebola, or it could be bioterrorism.

> There's no need to panic. We don't have to hoard cans of spaghetti or go down into the basement. But we need to get going, because time is not on our side.

Spot on. That's the novel coronavirus. We are not ready and that's why everyone is panicking.