Malaria, United States, Need Hong Kong discussed on The Portal
What are the likely scenarios for how we get it to something where people aren't asking come out of my house yet? I mean obviously at some level it could become normal that everybody shelters plays Ad Infinitum. It could become normal that we just say F and we throw caution to the wind and we all go out to on spring break in Florida. It could be that we come up with some sort of managed titrate where we titrate back into the world but nothing ever goes back to the way it was. What are the most likely scenarios that a competent and honest government would be able to level with us about if that was where we were with a smarter population in Smarter government to boot? So I would say is I think if you it's very there's a great website called in coronavirus dot org by guys out of the Northeast They're affiliated with Harvard And it basically shows that many countries have managed to get the virus. Hunter Control Basically You know through a combination of not just lockdown but Central Quarantine testing Border Control What does it mean to get the virus under control two things? It means number one that daily new cases are either zero or very close to that. And that's by the way the explicit goal of the head of New Zealand just arden. The Prime Minister of Singapore is get new cases zero number one and number two to keep the RT reproduction number Below one in the event that it does arise again And so basically keep it down and have at. Stay down right and for that to happen. You need to have a like not just according to society But a coordinated state you both citing the state to work together. There's some exceptions to this. I'd say Need Hong Kong is arguably a counter example where people say society did up at the state didn't But I think the first thing is it is possible to get the virus under control it is not an inevitability that goes to one hundred percent. I think is important point now. One can counter argue as to okay. How expensive is it to do that? Forever right will these green zones be able to keep themselves green and I kind of think they will or at least many of them will Because once you got an cases down to zero and you're sort of woke to the virus and you've set up your defenses I can get into what those defenses are technologically and societally. Because I don't think people in the west of really followed it too much. Should I talk about that okay? So here's here's just some of the things you might want to talk about green zones. Talk about the. Yeah well let me define it so so. A Green Zone is a place with comprehensive testing. That has no new cases in. Let's say the last two weeks. Okay you could change the time. Primary four weeks something but conceptually. That's right And it also keeps the virus from coming back to the reproduction number stays below one Independent. There is a red zone is everywhere else. And there's degrees of green and red and essentially the new developed world and developing world. I think is going to be green zones and red zones and that is to say talent and capital will prefer to be in green zones and to avoid or get out of red zones if they if it can and the reason for that is several fold I is like the and this premise. Which I'm surprised that I still have to argue it in May but the virus is serious and You know at first you might take a look at the death. Count's of course people would agree it serious a but people will throw various in my view spurious objections. The most I think. Intelligent objection is yes. There's eighty thousand deaths in the US. There's hundreds of thousands worldwide but they're concentrated older people and people with preexisting conditions and therefore You know much of the population is at risk. So at the Mat Lockdown. Go back to work. It's not a big deal for most people. My counter argument to that would basically be alright Other countries lockdown with just one component of what they did it it was it was an important component Cargo lockdown number. Two is the there's a lot of folks We don't know the exact number but there's many folks under age fifty who've had very serious conditions that are not lethal. They're not dead They may not always be hospitalized. But they're serious and You know whether you want to believe w not. Delicious reported like swimming. Nineteen percent of people have a severe or critical condition whereas eighty percent are mild If that maps to the experienced severity that folks You know that that I've seen people I know have had very severe cases. They're not dead. They're not hospitalized. But it's the worst illicit had in their lives have had very long condolescences weeks to months like eight weeks or so permanent on on this right. Are they permanently impaired for example lung? Tishreen ever comes back. Great Question So I tweeted on this March. Actually SARS in. Moore's there are studies. There's a group out of Ucla and I think David Geffen School Medicine Ucla USC the publisher a paper. Saying we need launch toodle monitoring of people who have recovered from covid nineteen to see if they have permanent damage. Because some a good chunk of folks with SARS immersed did So you know the thing about the long-term will only know it in the long term but I do think we should be doing longitudinal studies of patients. We should be quantifying morbidity better not just mortality yes? We need to know debt. Statistics across demographics very important. But we also need to know things like cellphones verity Duration vilnis length of convalescence meaning recovery after illness Self reported recurrence of symptoms And you know then things like CD. Scans like at thirty and sixty and ninety day intervals and other kinds of things do are people getting back? And here's the issue is even if it's just a just in quotes but just a very serious illness which knocks out you know. With some probability healthy thirty and forty year olds for eight weeks or ten weeks. That's something where you know. If if you had a choice you'd avoid an area where you could get that very easily. Your team would avoid Neria. They would not. You're not be able to recruit people to such a city very easily If they had a choice of an equivalent job somewhere else and So what would that does? Is it turns. You know the first thing in real estate from location location location to infection infection infection. It's deeper than that as well. People think Oh you know. End The lockdowns but the lockdowns doesn't by its own. Bring back the market. One way of thinking about it is Earlier made the analogy to an invasion invasion by virus. There's another analogy. I'm going to give in terms of public utility Our society is explicitly premised on electrical power. That is to say you know. There's there's power outlets for for all kinds of stuff and if the power goes out we wouldn't tell people. Oh just bull through it right because you need to charge your computer and you know you can't tell a restaurant. Oh just bowl through. Their oven doesn't work. They're not gonNA be able to serve too many customers. Maybe they can cobble together. But they're operating way below capacity. They won't be able to handle any APPS. Demand will be way down in lots of ways. People won't be able to get there and And won't be able to serve them supply with loss be down and so The the point I'm making is our society is also implicitly. Premised just like it's exponentially premised on power as well as water internet roads. It's implicitly premised on the absence of serious infectious disease from public venues and the thing is that fifty years ago. This was understood to be a big deal that is to say tweeted something on the Conquest Public Health Congress infectious diseases. You know bicentennial review. It was understood that getting you know cholera and malaria and stuff like that under control and turn them into non issues was a massive achievement and That was something that was accused social and technological achievement of coordination even like the banishing of malaria from southern Europe in the southern United States. You know led us to think in terms of malaria cannot be an American problem or in Italian. Yes bingo. That's exactly right. So the the issue is that Power and water are utilities that are noticeable by their presence but public health is noticeable by its absence and so you know just like like an electromagnetic pulse with me in the power has gone out in America. This is like the health is gone out in America. And so what would that means is? You can't just tell a restaurant bull through this okay. Because here's what happens. I like California. Put out these guidelines for in person restaurants how to reopen. I'm choosing restaurants as a working example because many of the things apply there. Okay I these guidelines essentially expect Joe's diner to implement biodefense moat. Okay it's like twelve pages of like the most ridiculous crimes get hand. Sanitizer get this. You can't even buy that stuff or if you can. It's expensive so I is. The restaurants are hit with new guidelines. They're not trained skilled in this kind of thing. They're great at cooking. Food not like sanitizing a a place to deadly virus Number two is. It's a new tax on them because they buy all the equipment and train their workers number three because of social distancing they have to space tables out so they have less revenue that was the opposite of a crowded restaurant right Number four off. They have fewer customers because half their customer base or whatever fraction basically like having uncontrolled virus means. Hey I'm risking at every time. I walked down and This is something that the folks who are arguing. Oh the virus isn't that bad because the mortality rates. You know it's not killing. Fifty percent of people in my argument is okay. Yeah sure relative to death you can say anything is not a big deal. Death is worse worst outcome right but relative to a cup of coffee or a slice of cheesecake or whatever at the local cafe Ten weeks of serious illness is not something that you want to casually risk for that. Say M- you know yes. Okay you can argue. The virus isn't as bad as dying fine. But it's also you know this consumer benefit you're offering is not as good as the risk of you know where it is in the middle right and and so one of conceptualizing that is. I'm not just like a economic Determinist by any means but for those people who are in the language of economics okay. Let's say that the virus would you know on on average do ten thousand dollars damage to you For example puts you out of work for that many weeks. You're make fifty thousand dollars a year puts you out of work for ten weeks okay. So let's say it does ten thousand dollars damage in the event of a serious case And you have a five percent chance of getting the virus and a thirty percent chance conditional on getting the virus having serious case in the cost. You Ten thousand dollars for ten weeks of sickness okay. That is Five percent thirty percent. Ten thousand one hundred fifty dollar cost that is now being imposed on every interaction. That has a chance of getting the virus right. And that's not worth it for many kinds of things and I'm not seeing. The people calculate that numerically and explicitly but implicitly. I think that that is going to be a tax on a lot of economic behavior. That many weeks you're make fifty thousand dollars a year puts you out of work for ten weeks okay. So let's say it does ten thousand dollars damage in the event of a serious case and you have a five percent chance of getting the virus and a thirty percent chance conditional.