Flatten the Curve or Eliminate the Virus?

[cmarshall]

20 minutes ago, Mama Noodle said:

 

Here we have 2 completely different approaches to Covid. Sweden and Taiwan. Sweden followed the logic of most western, developed nations that the virus is going to run its course. Taiwan felt that it could contain and eliminate the virus. These 2 approaches are completely different so comparing them is a false equivalence. 

 

SARS and MERS petered out on their own before a vaccine was even needed, so it was just dumb luck yet again that it wasn't worse. Also a false equivalence. 

 

Sweden does not have a "maximizing death" policy no more than anyone else who is going by the generally accepted science that after a certain infection point, the virus is going to run its course no matter what you do, even when you "Flatten the Curve" you are just spreading it out over time.

Thanks for your contribution every point of which is wrong.  SARS and MERS were contained by intensive efforts.  In the case of SARS the Chinese government used severe methods to prevent the spread.  I remember that a the SARS patients were kept in a single hospital that was ringed with armed soldiers.  The virus did escape briefly to Toronto and Singapore where it was contained by the public health services there.

 

The best practice for containing an epidemic virus is to test, isolate positives and trace contacts for further testing and isolation.  We know this works.  This is the method that the US CDC promotes along with the WHO and others.  It has worked spectacularly against corona in S. Korea, Taiwan, Hong Kong, Australia, and New Zealand who are all essentially free of the virus at this point with a tiny number of deaths.  Sweden failed to implement this plan and so the virus escaped.  The neighboring countries of Norway, Denmark, and Finland did follow the best practices and currently have death rates much lower than Sweden's.  

 

So, this is not a case of cherry vanilla is just as good as pistachio.  There is the competent implementation of known best practices or there is gross incompetence aggravated by indifference to the lives of the citzenry, i.e. Sweden.  Despite's Sweden's willingness to sacrifice its citizens it's economy is down 10%.

 

Efforts to develop vaccines against SARS, MERS, and HIV have continued for years, but have all failed.  A successful vaccine against Covid is by no means assured.  Both SARS and MERS are coronaviruses, by the way.

 

Comparing the effectiveness of anti-pandemic strategies is just as easy as it looks.  Sweden has 3,000 deaths and climbing while Taiwan has six.  China recently announced that there are now no hospitalized Covid patients in Wuhan.  The number of new cases in China is close to zero.  So, China's death toll will never catch up to the incompetent Americans.  You may wish that the future will vindicate the incompetent Western governments, but it is just another fantasy.

 

 

[Henryford]

Can you "eliminate" the virus. How did that work out for the cold/flu viruses?

Edited May 9, 2020 by Henryford

[Mama Noodle]

1 minute ago, Laza 45 said:

If you look at the countries that have been most successful at containing the virus...Taiwan, South Korea, Australia, New Zealand and China and Thailand too....all these countries enforced stay at home, social distancing, wearing of masks, hygiene with sanitisers etc..

 

Lets just take a look at Thailand. Outside of Bangkok and especially out in the provinces, it is pure luck that there wasn't a worse result than what's being reported. If masks and hand gel were the cure then the planet wouldn't have a problem - but we know that isn't the case. I can tell you that in the province I live there have been several cases (none now for a while) but they were all mostly individual cases and only counted because they were very sick and fit a certain criteria. So one guy gets sick - you'd think his whole household would be sick as well, but they aren't. 

 

Point is that there are other factors at play that we don't yet know about, which should be obvious to anyone paying attention. 

[cmarshall]

8 minutes ago, Laza 45 said:

If you look at the countries that have been most successful at containing the virus...Taiwan, South Korea, Australia, New Zealand and China and Thailand too....all these countries enforced stay at home, social distancing, wearing of masks, hygiene with sanitisers etc.. they have all reached a point now where they can now quickly identify new infections.. act quickly and prevent the spread.. They are all in a position to carefully open their economies again.. they are the winners in the race to 'open up'.. they will be the first to open their tourism industries.. the first to open trade between each other..  and they are now in a position to react quickly to any threat of a second wave..  ...the alternative?  ..look at the US total chaos.. and no end in sight..

More to the point they all tested, isolated those were were positive, and then traced their contacts.  Taiwan actually never did extensive testing of the population, because their contact tracing was meticulously done, so they focused the testing where it was needed.

 

This is not rocket science, but it is laborious.  It has been the standard regimes practiced against other epidemics for years, such as Ebola in Africa.  Sweden attempted to do testing, isolating, and contact tracing, but they started too late and the virus had already overwhelmed their public health resources.  So, they just gave up and developed a bogus rationale for their failure that all other countries would fail as well, never accounting for the five successful examples you mention.

 

Utterly despicable.

[thaibeachlovers]

30 minutes ago, cmarshall said:

Reading skills not quite up to snuff?  Taiwan never had a full lockdown.  New Zealand and Australia, who also managed the infection extremely well and have effectively eliminated the virus, are considering retaining the ban on incoming flights and allowing travel only between their two countries.  That's how you keep the infection out until it has run its course among the badly governed nations.

Unless you are in NZ you should not use such words as "managed" "extremely well" and "effectively eliminated". Only thing done well, IMO, was closing the border. The government has just been lucky, IMO. The virus has not, of course been eliminated. The virus is with us always from now on, and is just waiting for end of lockdown and new victims, IMO.

[cmarshall]

9 minutes ago, Henryford said:

Can you "eliminate" the virus. How did that work out for the cold/flu viruses?

If you were willing to undergo the intensive public health burden of testing, isolating infected individuals, and tracing their contacts for more isolating, yes, you could contain common cold viruses and flu viruses.  But each year there are new mutated versions of those viruses, so you would have to carry out that intensive operation every year.  Instead they try to guess which flu strain will dominate for the coming season, develop a specific vaccine against that strain, and innoculate as many people as possible to achie as much herd immunity as they can.  Some years it works well when the guess about the dominant strain is correct.  Other years, they miss entirely and the vaccine fails.   The common cold viruses are generally non-lethal, so they don't devote the effort there.

 

What you can't eliminate with the flu virus is the generation of a new strain the next year because a duck virus crosses into the pig population in China and creates a new strain for humans each years.  You might eliminate it completely if you could persuade the Chinese to go vegan completely.

 

By contrast the small pox virus did not mutate much if at all.  So, it was eliminated in the 1980's, permanently as far as we know.  The measles virus apparently does not mutate, but there is an effective vaccine, so elimination is not paramount.

Edited May 9, 2020 by cmarshall

[PingRoundTheWorld]

Most governments are just loving the amount of control this gives them, so the narrative will keep evolving so they can keep as much of it as possible. They don't care at all about how many people they hurt doing this, and they knew the economy will be devastated - they just don't care because it benefits them, at the expense of everybody else. Eventually the entire population (or at least a big percentage of it) will get infected anyway and develop herd immunity - it's just a matter of time. It's better to get it over with quickly like Sweden is trying than drag it on for years like, say, New Zealand.

[Mama Noodle]

15 minutes ago, cmarshall said:

Thanks for your contribution every point of which is wrong.  SARS and MERS were contained by intensive efforts. 

 

SARS, MERS, Ebola were much less infectious and much more fatal, completely different than Covid 19. Comparing them is a false equivalence. They just did not have the legs to be a global pandemic any way you cut it. 

 

I travel constantly for my work all across the middle east and asia, only thing I saw in my travels were signboards talking about coughs and IR cameras to check temps. In other words, barely any international mitigation. 

 

18 minutes ago, cmarshall said:

In the case of SARS the Chinese government used severe methods to prevent the spread.  I remember that a the SARS patients were kept in a single hospital that was ringed with armed soldiers. 

 

Another false equivalence here. There is little doubt that communist regimens are more than capable and quite good at strong-arming their people into lockdowns. Does that make them better? Does that make them better governed? In my view and I think most peoples view it does not. 

 

 

[thaibeachlovers]

46 minutes ago, Laza 45 said:

If you look at the countries that have been most successful at containing the virus...Taiwan, South Korea, Australia, New Zealand and China and Thailand too....all these countries enforced stay at home, social distancing, wearing of masks, hygiene with sanitisers etc.. they have all reached a point now where they can now quickly identify new infections.. act quickly and prevent the spread..

Re NZ ( I can't speak for the others ) social distancing, wearing of masks, You've been following the propaganda- social distancing yes, OUTSIDE, but where people are allowed to congregate not much, and masks are NOT required - where I live hardly anyone wears one.

I can only speak for where I live as we are not permitted to travel far and I have not done so.

 

reached a point now where they can now quickly identify new infections.. act quickly

Do tell. Some would disagree with that.

 

There are virtually no new cases and only 22 deaths- IMO due in the main to border closure and 14 day quarantine for all arrivals.

According to many, we should have been released from level 3 lockdown 2 weeks ago.

 

Edited May 9, 2020 by thaibeachlovers

[thaibeachlovers]

14 minutes ago, PingRoundTheWorld said:

Most governments are just loving the amount of control this gives them, so the narrative will keep evolving so they can keep as much of it as possible. They don't care at all about how many people they hurt doing this, and they knew the economy will be devastated - they just don't care because it benefits them, at the expense of everybody else. Eventually the entire population (or at least a big percentage of it) will get infected anyway and develop herd immunity - it's just a matter of time. It's better to get it over with quickly like Sweden is trying than drag it on for years like, say, New Zealand.

According to the government's own published rules, as I understand it NZ should already be back to almost normal, but with closed borders. We are not, and in the opinion of many ( that call talkback radio ) it is because the government does not wish to give up the control it has ( I can't speak as to whether that is the truth or not, but IMO seems likely ).

Meanwhile small business fail and the dole q lengthens.

 

IMO the only ones that want to continue the lockdown are those that have a guaranteed income ie government employees and people on pensions etc.

[Laza 45]

An excellent article on how Australia has been successful:  

 

 

https://www.smh.com.au/national/three-decisions-and-a-two-point-plan-how-australia-got-on-top-of-covid-19-20200508-p54rag.html?fbclid=IwAR1eBFS9utFFxjVf5zaMJOQQxNA4bzt_JLqmjsy4t5DXqberBCiZ43JbSg4

[4MyEgo]

11 hours ago, Mama Noodle said:

Yes, In some areas of those countries SOME hospitals were nearing being overwhelmed and lockdowns flattened the curve and relieved the stress. But most hospitals globally have not been anywhere near being overwhelmed. 
 

America has a huge landmass and large population. What happens in New York does not need to apply to Florida (for example). 
 

So what do we do. Thailand for example is wrecking its economy over 50-something deaths. Does that seem reasonable to you? Doesn’t to me. 
 

 

I think this is all a learning curve, example, your walking along and see all these people running in your direction screaming, you would automatically turn and run and try asking people passing you what is happening while you're also running in fear.

 

So you have started running without knowing what is happening, same applies here, so to speak, albeit it countries had time to think, but leaders were advised from professionals in their respective fields and then had to make a decision, right or wrong, when the sheeet hits the fan, if it ever does, then they will fall on their swords, or should I say, be pushed onto their swords, that said, Trump is going to lose the next election IMO, people need someone to blame.

 

Welcome to the new world. going to take a while for a lot of people to get back on their feet, change of jobs, loss of properties, change of countries and lifestyles, for those who have money as back up, will not be impacted.

 

[cmarshall]

48 minutes ago, Mama Noodle said:

 

SARS, MERS, Ebola were much less infectious and much more fatal, completely different than Covid 19. Comparing them is a false equivalence. They just did not have the legs to be a global pandemic any way you cut it. 

 

I travel constantly for my work all across the middle east and asia, only thing I saw in my travels were signboards talking about coughs and IR cameras to check temps. In other words, barely any international mitigation. 

 

 

Another false equivalence here. There is little doubt that communist regimens are more than capable and quite good at strong-arming their people into lockdowns. Does that make them better? Does that make them better governed? In my view and I think most peoples view it does not. 

 

 

Not true.  SARS reproduction rate comparable to Covid-19:

 

R ₀ estimates for SARS have been reported to range between 2 and 5, which is within the range of the mean R₀ for COVID-19 found in this review. Due to similarities of both pathogen and region of exposure, this is expected. 

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074654/

 

Of the 5 governments cited that have succeeded in containing Covid, which is S. Korea, Taiwan, Hong Kong, Australia and New Zealand, only Hong Kong may be considered a communist country, and then only partially.  

 

Keep ignoring the facts and try to believe that the Western countries are somehow competent.  Meanwhile, be grateful that you live in Thailand.

[Mama Noodle]

39 minutes ago, cmarshall said:

Not true.

Just so we are very clear on what you are proposing here, and what your point is:

 

You do not agree that SARS, MERS, and Ebola are much less infectious and much more fatal? 

 

42 minutes ago, cmarshall said:

Keep ignoring the facts

 

Im not ignoring anything, I am all-in on an objective discussion but unfortunately, for some reason, it is you that is ignoring 'facts' and tossing aside objectivity. 

[cmarshall]

2 minutes ago, Mama Noodle said:

Just so we are very clear on what you are proposing here, and what your point is:

 

You do not agree that SARS, MERS, and Ebola are much less infectious and much more fatal? 

 

 

Im not ignoring anything, I am all-in on an objective discussion but unfortunately, for some reason, it is you that is ignoring 'facts' and tossing aside objectivity. 

Not me, but the US National Institute of Health wrote that the infection rate of SARS is comparable to Covid-19.  Do you miss the citation?  I don't have the figures on MERS and other epidemic diseases.

 

But whatever the reproduction rate of the infection or the IFR the best practice is the same: test, isolate, trace contacts.  This method was successful against SARS.  It worked against Ebola led by the Obama government.  It has also worked against Covid not only in the 5 countries cited, but also in Mainland China after they initially bungled their response requiring them to lockdown first Wuhan and then Hubei Province.  Subsequently, the Chinese government never had to lockdown the whole country although they did put in social distancing and enforcement quarantines of infected persons, along with testing, isolation, and contact tracing.  And they succeeded. Today China has a very low new case rate.

 

You evidently believe that it was the unique contagion rate of Covid that made it uncontrollable rather than the gross incompetence of all of the Western countries who squandered their opportunity to apply the proven best practices of the Asian countries.  Well, that case is demonstrably untenable.

 

Here's China's new case rate against the US on a log scale.  As you can see China never had the sustained new case rate that the US currently has even though they cat got out of the bag.  

 

[chessman]

11 hours ago, Kinnock said:

SARS faded out after mutations and/or herd immunity ..... I was working in HK and Taiwan at the time, and thrre's no way the government controls had any real impacts.

This is just not true! Sars stopped because as more research was done with it, it was discovered that it only became transmissible quite late after people got it. This meant if you could catch early cases and quarantine them completely you could eliminate it. This happened. This is much more difficult to do with COVID because there are more asymptomatic carriers and it might be transmissible earlier after it is caught.

 

But it wouldn't be impossible for all the research being done now to find something that was effective in fighting it.

[chessman]

15 hours ago, Mama Noodle said:

The narrative on managing Coronavirus seems to be shifting to something way off from what was once "Flatten the Curve". Economies were shut down to do just that, flatten the curve. 

 

The objective was to flatten the curve so that hospitals don't get overwhelmed. At least in the USA that hasn't happened. Nobody who needed care was unable to get care. Flattening the curve meant the same amount of people will get hospitalized and possibly die, but over a longer period of time. 

 

Now the narrative is trying to be changed by some to be "Test and Trace" and "Testing Testing Testing" in order to open up economies and get things moving again, and I agree testing is a good tool but it shouldn't stop economies from opening up. 

Are there many economies that are not (slowly) opening up now or have planned dates in the near future?

 

Seems it's almost a trick of time, we think nothing is changing but actually most countries which had a really bad March will be significantly more open in May, no?

 

It also makes sense for countries to try to do this slowly. Incrementally open things up and see how that effects new cases.

[cmarshall]

21 minutes ago, chessman said:

This is just not true! Sars stopped because as more research was done with it, it was discovered that it only became transmissible quite late after people got it. This meant if you could catch early cases and quarantine them completely you could eliminate it. This happened. This is much more difficult to do with COVID because there are more asymptomatic carriers and it might be transmissible earlier after it is caught.

 

But it wouldn't be impossible for all the research being done now to find something that was effective in fighting it.

But we already know the answer to that.  For a while Thailand was the center of infection outside of China.  Then S. Korea surpassed Thailand and became # 2.  But S. Korea had already put into place a huge testing program which they had planned as part of the reforms after they bungled MERS.  In Dec. 2019 they organized 20 Korean companies to produce test kits in quantity.  They set up drive-in test sites.  They isolated positives and did contact tracing.  S. Korea has a population of 51 million right next to China.  Their number of infections is about 11,000 and the number of deaths is 256.  Their daily new case count is 5.

 

So, why are you in doubt as to how effectively to fight Covid?  What is the part of this that you are not getting?

 

[tlock]

I'll be honest- I don't want the lockdown strategy to be proven effective.  Because I don't think it's scalable.  There are 500 more coronoviruses in the bat caves.  In the last 20 years we've had SARS, MERS, H1N1, and now SARS-2.  It's almost guaranteed that we will see another one within the next 10 years.  

 

I firmly believe there is a deep health cost to mass unemployment, but that seems to be swept under the rug in favor of simply looking at the current number of deaths no matter how many studies I link, so I won't proceed with that particular argument.

 

But my view is even in the best case scenario of the pro-lockdown crowd, we stay locked down until a vaccine is found, we force enough people to be vaccinated to somehow eliminate the virus, we provide a basic income so people have enough food to eat while staying in their homes, and then finally things begin to recover in a couple years.  People are going to discos standing 6 feet away from each other wearing masks, we get used to eating in restaurants with barriers between seats.

 

And then a new virus is discovered.  

 

The main criticism I see is that we didn't lock down soon enough, or harshly enough.  So next time we get even more draconian.  We immediately stop doing everything and go back to our homes and shelter in place and wait for the next vaccine.  

 

It seems like it would only take 2 or 3 iterations of that to completely decimate world economies and any reasonable standard of living?  

 

If this was a once in a lifetime event, I could stomach it.  But if we don't come out of this realizing it was the greatest gaffe in the last 100 years, we're effed.

 

[chessman]

29 minutes ago, tlock said:

in the best case scenario of the pro-lockdown crowd, we stay locked down until a vaccine is found

I genuinely don't know anyone who thinks this or have read one person who has recommended this.

 

People have said things won't be back to normal until there is a vaccine but this is very different.

[tlock]

5 minutes ago, chessman said:

I genuinely don't know anyone who thinks this or have read one person who has recommended this.

 

People have said things won't be back to normal until there is a vaccine but this is very different.

 

Fair enough- so if we just lockdown the way we just have for 2 months every 5-10 years?  Is that a scalable solution in your opinion?  

[chessman]

39 minutes ago, tlock said:

If this was a once in a lifetime event, I could stomach it.

Unless you're 102 and were around for the Spanish flu, this is a once in a lifetime event.

[chessman]

1 minute ago, tlock said:

Fair enough- so if we just lockdown the way we just have for 2 months every 5-10 years?  Is that a scalable solution in your opinion?

But this is the first time something like this has happened in our lifetimes. Am not sure why we should expect it to happen every 5-10 years.

 

What is more likely to happen is that countries become more prepared (as South Korea did) and are ready to take on the virus from the moment there are confirmed cases.

[chessman]

51 minutes ago, cmarshall said:

But we already know the answer to that.  For a while Thailand was the center of infection outside of China.  Then S. Korea surpassed Thailand and became # 2.  But S. Korea had already put into place a huge testing program which they had planned as part of the reforms after they bungled MERS.  In Dec. 2019 they organized 20 Korean companies to produce test kits in quantity.  They set up drive-in test sites.  They isolated positives and did contact tracing.  S. Korea has a population of 51 million right next to China.  Their number of infections is about 11,000 and the number of deaths is 256.  Their daily new case count is 5.

 

So, why are you in doubt as to how effectively to fight Covid?  What is the part of this that you are not getting?

No arguments from me, I'm pretty certain that when the dust settles and people analyze went wrong, the conclusions will be centered around  a lack of preparedness and then not taking action when it was clear that what was happening in Wuhan was serious.

[natway09]

Maybe the herd immunity went through Thailand in early December ?

I do not know.

A real bummer is Sth Korea yesterday where the bars opened up & 50 reported cases already

[tlock]

18 minutes ago, natway09 said:

Maybe the herd immunity went through Thailand in early December ?

I do not know.

A real bummer is Sth Korea yesterday where the bars opened up & 50 reported cases already

 

I think that's kind of the point of the OP- flatten the curve never meant eliminate the virus.  Any re-openings will lead to more cases.  I think it's possible we are still finding cases in 10 years, unless we forcibly vaccinate the entire planet.

 

 

[nemo38]

Initially a couple of weeks of closing borders and wearing masks were justified. Empty hospitals and mortality rates (actual mortality rates) of a regular flu told us we need to get back to work. Old people, and those with morbidity, die every year from flu. It is sad, but we don't close the country for a problem that is much less serious than heart disease.

 

When you consider studies showing 1% increase in unemployment causes a 1% increase in suicides the lockdown is a travesty. We should be criminally prosecuting leaders for destroying our economies.

 

https://www.reuters.com/investigates/special-report/health-coronavirus-usa-cost/

 

On top of that they should be prosecuted for trying to introduce restrictions on free speech and more control of the population.

[sawadee1947]

On 5/8/2020 at 2:51 PM, Mama Noodle said:

More people died in road accidents in ONE DAY in Thailand after the booze ban was lifted than ALL of the reported Covid deaths combined.

Oh dear, another Buddy of Donald. 

The more people are tested the more cases you'll have. And that Thailand got only a marginal number of cases or deaths doesn't mean the virus avoided Thailand. 

Just compare Thailand's testing number of 10.000 a week with 500.000 per week in EU countries! 

Do your own mathematics. 

Thailand's economy is build on tourism. 

No tourists no income 

So it's quite obvious to have a low or no number of cases hoping that the tourists will come back soon. 

Marter your own brain. 

And somebody who is still thinking Corona is comparable with a flu can't either think or read or got a lack of knowledge or common sense or even brain maybe. 

[johnnybangkok]

On 5/9/2020 at 8:22 AM, Mama Noodle said:

 

SARS, MERS, Ebola were much less infectious and much more fatal, completely different than Covid 19. Comparing them is a false equivalence. They just did not have the legs to be a global pandemic any way you cut it. 

 

I travel constantly for my work all across the middle east and asia, only thing I saw in my travels were signboards talking about coughs and IR cameras to check temps. In other words, barely any international mitigation. 

 

 

Another false equivalence here. There is little doubt that communist regimens are more than capable and quite good at strong-arming their people into lockdowns. Does that make them better? Does that make them better governed? In my view and I think most peoples view it does not. 

 

 

You keep lecturing people on their 'false equivalence' when your original post is nothing BUT false equivalents.

'More people died in road accidents in ONE DAY in Thailand after the booze ban was lifted than ALL of the reported Covid deaths combined' - literally comparing apples with oranges.

 

'New York State has a population slightly less than the State of Florida, yet Florida has 1600 deaths VS New York's 20,800 deaths' - completely different population density, more people coming in and out from overseas and Florida is a LOT warmer (although the jury is out onn this one there seems to be eveidence it is a contributing factor).

 

'Its really rather stupid when you consider a good baseline is 2017/2018 flu season where a suspected 60,000 - 80,000 people died in the USA alone and no one batted an eye - just that it was "A bad flu season". - will you PLEASE stop comparing this to the flu. C19 is much more contageous and much more deadly. This is a fact.

 

You also are talking about a debate on the matter, but when faced with solid, fact driven evidence from the likes of cmarshall you refute each and every point he is making. So what is it? Do you want a debate or do you just want to hear from those that feed into your own echo chamber and sunstantiate your own position? 

 

[tlock]

 

31 minutes ago, sawadee1947 said:

Oh dear, another Buddy of Donald. 

The more people are tested the more cases you'll have. And that Thailand got only a marginal number of cases or deaths doesn't mean the virus avoided Thailand. 

Just compare Thailand's testing number of 10.000 a week with 500.000 per week in EU countries! 

Do your own mathematics. 

Thailand's economy is build on tourism. 

No tourists no income 

So it's quite obvious to have a low or no number of cases hoping that the tourists will come back soon. 

Marter your own brain. 

And somebody who is still thinking Corona is comparable with a flu can't either think or read or got a lack of knowledge or common sense or even brain maybe. 

 

I think trump is an idiot, but I also think extending the lockdowns will have more devastating consequences long term than lifting them.