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Coronavirus Solution

Coronavirus: The Hammer and the Dance explains what everyone should know about governmental and societal policies for dealing with Coronavirus. Millions will die needlessly unless we change policies. (Some Asian countries have good policies. North American and European countries don't.)

Summary: Absolutely don't give up and intentionally let everyone get the disease. And we don't need total lockdown for 18+ months to wait for a vaccine, either. Instead, we must immediately do roughly 4-6 weeks of lockdown to get the disease under control (every day counts against an exponential pandemic). Once it stops spreading exponentially, we can manage it using testing and contact tracing, and ongoing mild and cost-effective lockdown measures while awaiting a vaccine. Any time spent on half-measures right now is condemning people to die and hurting the economy without solving the main problem. If we don't get this right, the hospital system will be overwhelmed and millions will die as hospitals turn them away. We're already on course for disaster, in a matter of days, if we don't make this policy change.

Do we really need to take drastic measures? Yes. Read about how harmful the disease is: A Medical Worker Describes Terrifying Lung Failure From COVID-19 — Even in His Young Patients (the article is about a hospital in New Orleans, in Louisiana, in USA).

In Wuhan, the disease peaked a month after they did a full lockdown. In Italy today, despite the ongoing disaster (they've passed China in deaths), their lockdown is still inadequate.


Elliot Temple on March 21, 2020

Messages (12)

It seems to take a lot of fear or force/authority before people change their behavior and isolate. It shouldn't, but as a practical matter for ~everyone it does. Until the force/authority of government compels people to do the right thing the only thing that works is fear.

Suppose someone will listen to enough information to become fearful and self-isolate for now.

Then the fear itself becomes a problem - leading to not just feeling bad but not being able to sleep, loss of appetite, raise in blood pressure, listlessness, hyperventilating, stress-eating, etc. Less fear than that and they would still go out and do dumb shit.

Don't get me wrong: the fear is a better problem to deal with than having the virus. But still a big problem, and one that could cause nasty snap-backs ("fuck it, I'm tired of living this way, if I die I die", "I want to drink to forget all this").

Any suggestions for dealing with that?


Andy Dufresne at 3:32 AM on March 22, 2020 | #16091 | reply | quote

#16091 Depends on the person. A few suggestions:

Don't be an emotionalist.

Learn philosophy. Learn anything.

Learn about viruses. Demystify the enemy.

Distract yourself. Books, video games, TV. Find something you can get lost in for weeks, like a new one that sucks you in.

Do stuff you regard as productive, have wanted to do for a long time, and can do at home.

Understand what the dangers are better. You should be scared if you and others are going out like normal. But if you're staying home, your risk is low. The fear should prevent risky activities and get you to do low risk activities, and you should feel fairly safe while you're avoiding the risky activities. Associate the fear with the dangerous stuff not with all of life.


curi at 10:24 AM on March 22, 2020 | #16092 | reply | quote

15 Days to Slow the Spread was posted by the U.S. Whitehouse on March 16.

It is *not* the hammer. It's not close. It's half-measures (maybe tenth-measures) which are likely to kill over a million Americans compared to the hammer and dance strategy.


Dagny at 3:39 PM on March 22, 2020 | #16095 | reply | quote

New Zealand about to do the Hammer and the Dance. 102 confirmed cases in NZ.


Anonymous at 6:27 PM on March 22, 2020 | #16098 | reply | quote

Massive pressure went on the NZ govt to do the Hammer and the Dance. They should have done it earlier. And it is not being implemented until Wed. But they are at least going to do it. And some of the pressure arose from information posted on this blog. Thank you for doing really good work. The problem now is getting all NZers to treat it really seriously.


Anonymous at 12:17 AM on March 23, 2020 | #16103 | reply | quote

Hydroxychloroquine for Covid-19

Hydroxychloroquine is an existing drug that is now being used by some doctors to treat Covid-19 with great results (one NY doctor used it on over 700 patients resulting in zero deaths):

https://townhall.com/columnists/kevinmccullough/2020/03/29/hydroxychloroquine-help-is-on-the-way-n2565926?fbclid=IwAR262aUcSmgx6RpJ3DZXAIAWIo5FOPxtHDGN64L42-w_57Jl5I-rDB9Ks4w

-----

Company awarded $750,000 by US government to do a 1-month study of Hydroxychloroquine for Covid-19:

https://www.buzzfeednews.com/article/jasonleopold/new-government-study-of-chloroquine-after-trump-comments

-----

Hydroxychloroquine is an existing drug, e.g. used for malaria and lupus. So it's already in production and production is now being ramped up.

FDA changed their rules to allow the use of this drug for emergency cases even though no study has been done yet. I hope this policy continues in the future for all diseases.


GISTE at 6:25 AM on March 30, 2020 | #16195 | reply | quote

Originally posted on Discord.

At what point has the mitigation [] been in action for such a long time that a hard lockdown (Hammer) is no longer the better strategy? When is it better to do something else?


n at 5:45 AM on April 2, 2020 | #16226 | reply | quote

#16226

It is better to use the dance strategies whenever you can. It would have been better to use them initially, as Taiwan did. Once our numbers are low enough that we can use them, it will be better to use dance strategies. That will require the government actually preparing enough & being able to implement them well though.

But I think you are asking when it is better to do something besides the Hammer & Dance - what if the hammer takes too long? Is there a point where it is better to just let the disease run its course, to save the economy?

There's no point where it would be better to just let the disease run its course (without already having vaccines, treatments, etc). The death rate is too high. It would kill millions of people and overwhelm the healthcare system. People would die of other things too, not just covid, because the hospitals would be overwhelmed. We would lose healthcare workers to exhaustion and covid and suicide and PTSD. These things are *already happening* even though we have mitigation strategies. Things in Italy, Spain, NYC would be SO much worse if they hadn't shut down. Things would get bad enough that people would be afraid to leave their houses.

One way to stop from overwhelming the healthcare system would be to just stop admitting covid patients. We'd not want to admit ANY covid patients, since any positive patients could transfer it to other patients. We could maybe set up extra hospitals just to take covid patients, but we wouldn't have the capacity to take ALL of them - we'd have to just take young people with no pre-existing conditions or something. The people we are most likely to save. Even offering comfort care to higher risk patients would overwhelm the system. We don't have enough doctors & nurses to deal with that. But then where would those patients go to die? Home with their families to die there, gasping for breath? I know if anyone who advocates letting the disease run its course has thought through the reality of this.

One idea people have is to just segregate all the old people & those with health conditions. One thing to consider - that's already what nursing homes ARE. They are segregated old people. And those have led to really high death rates because once it gets into a nursing home, a lot of people die. There is no way to fully segregate nursing homes - they need staff. I don't think we would be able to get enough people to volunteer to leave their families & work in a nursing home for the next 18 months or whatever. And even if we could, they also need healthcare, food, supplies, people to come and fix things that break, etc. We can't just fully segregate them. All it takes is one person bringing it in, and a bunch of people die.

Another problem with that idea is that 40% of the US population is "high risk". 40% of people are either over 65 or have a health condition. How could we segregate 40% of the population? Where would we put those people even if we COULD segregate them? (Which, as I said above, we can't - they will still need food, healthcare, etc.)

There is no reasonable way to just let this run its course. We don't even know the death rate yet - we know that it's too high for the healthcare system to deal with. And we know that if we let it overwhelm the healthcare system, it will be even higher because people with covid won't get proper treatment, and neither will anyone else.

Are the people who want to just let it run its course willing to just let 1-5% of the population die? Do they think that will somehow save the economy?


ingracke at 6:11 AM on April 2, 2020 | #16227 | reply | quote

It is possible that there will be other things we could do that would help.

Like, maybe it would work to infect healthy people with really low amounts of the disease - maybe healthy people could volunteer to become infected & quarantine, and that could help us build up towards herd immunity.

But that is basically a type of treatment. That's an old-fashioned way to do something like a vaccine. We would need some research to even figure out how well it works.

I wouldn't call that an alternative to the hammer & the dance. It is a type of medical treatment. A crude one, but still medical treatment that requires research to even figure out if it works well, how safe it is, etc.

One of the things that we are currently buying time for is more medical research. If we can figure out some kind of treatments that would work, that would be great, and could change our dance strategy.

We can also learn more about how the virus actually spreads, what kills it, what we need to be careful of, when people are contagious, etc. Those things would all also help us with a more successful dance strategy.

None of those things are really alternatives to what I would consider the dance strategy - they are part of it.


ingracke at 6:23 AM on April 2, 2020 | #16229 | reply | quote

> At what point has the mitigation been in action for such a long time that a hard lockdown (Hammer) is no longer the better strategy? When is it better to do something else?

(written and posted before reading ingracke's replies)

Very roughly, it's too late when 50% of the population has already been infected. Before that it's still plausible and worthwhile to (mostly) stop the spread by doing hammer.

It depends on speed of spread too. If 60% have been infected but only 2% are currently infected and 48% are recovered, then definitely do hammer to save the other 40%.

But if 50% have been infected and 40% are currently infected, that sounds like probably too late. If people would actually listen and do everything right, and all start the hammer today, it'd still be good to save a lot of people from infection. But with disobedience, carelessness, some spread due to essential business, spread to family members while staying at home, etc., maybe it'd be time to give up on stopping it.

Actually no wait, I think that's wrong. That was my first thought and I won't edit, but there's a major issue I didn't factor in. If 40% are currently infected, the hospitals are overwhelmed. That's really bad. It's still quite possibly worth it to hammer, even if it doesn't exactly work and everyone ends up infected, just to flatten the curve some. Like if the last 10% of the population (that get infected) get infected late, at least they'll have hospital resources available and therefore only have maybe a 0.66% death rate instead of the 4%.


curi at 12:19 PM on April 2, 2020 | #16235 | reply | quote

> There's no point where it would be better to just let the disease run its course

If 99% are already infected, we can give up on social distancing, stop staying home, etc.

What about giving up at 95%? 90%?

There is some point. We are nowhere near it and it's not an important or useful issue to more precisely figure out what the point is. But it exists.


curi at 12:57 PM on April 2, 2020 | #16238 | reply | quote

#16238

Oh, yes, I agree with that.

I was interpreting the question as meaning something more like: Assume the hammer is working, but it is going on too long. After how many months do we just give up and let people die to save the economy.

That is a common question/point I have seen brought up repeatedly, so that's what I took it to mean. There are people who think that waiting 18 months for a vaccine is too long, and as soon as we let up we will have the deaths, so we should just let up now instead of prolonging it. I was arguing against that.


ingracke at 2:21 PM on April 2, 2020 | #16239 | reply | quote

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