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Alex_Krycek

Comparing Corona Virus Success Stories with Abysmal Failures

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I would agree.
And thanks for the info, INow.

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Meanwhile:

https://www.yahoo.com/news/japanese-island-suffering-avoidable-second-100937097.html

Japan is experiencing a second wave of coronavirus infections - and deaths - that experts say could have been avoided if the state of emergency had not been lifted too early.

The island of Hokkaido had been held up as a model of how to control the spread of the virus, but it has now become a case study for the impact the disease can have if a lockdown is relaxed too soon.
<...>
Assuming that they had weathered the storm - and keen to get the local economy operating again - local authorities lifted the state of emergency on March 19, with schools and businesses reopening.

With hindsight, experts agree, it was too early and, just 26 days later and after 135 new infections were reported in the space of a week, the lockdown was reimposed on Hokkaido’s 5.3 million residents.

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Posted (edited)
7 hours ago, iNow said:

5.3 million residents down to 1 or 2 new cases per day does seem reasonable to lift some restrictions. The question would be how much. With just 135 new cases (reported) in a week, hopefully they will make the right adjustments and get back on a more cautious track.

I don't think we will really be able to safely open up to much of a degree anywhere without a number of the right things in place. They may have, but just relaxed restrictions to far, opening up schools and businesses (they don't make it clear to what degree)

In comparison, the province of New Brunswick, with similar land area but about a seventh the population, after over a week of no new cases reduced restrictions almost a week ago and have so far no new cases. They still haven't reopened schools and I think business restrictions stayed much the same at this point. (also not an island, but cross border traffic is mostly trucking with all borders restricted)

I think the keys are caution, testing, and the ability to respond as new information emerges. One might argue Hokkaido did it right if more was known, but were just a little unfortunate and now need to gear down. Obviously 135 new cases in a week won't overwhelm their health care system.

Compare also to the Province of Quebec, much larger than Hokkaido but comparable population. They are planning to reduce restrictions fairly soon but still have around 800 new cases per day...hopefully not before they have a chance to rethink this, at least for the more urban areas or hot spots.

Edited by J.C.MacSwell

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Posted (edited)
1 hour ago, J.C.MacSwell said:

5.3 million residents down to 1 or 2 new cases per day does seem reasonable to lift some restrictions. The question would be how much. With just 135 new cases (reported) in a week, hopefully they will make the right adjustments and get back on a more cautious track.

I don't think we will really be able to safely open up to much of a degree anywhere without a number of the right things in place. They may have, but just relaxed restrictions to far, opening up schools and businesses (they don't make it clear to what degree)

In comparison, the province of New Brunswick, with similar land area but about a seventh the population, after over a week of no new cases reduced restrictions almost a week ago and have so far no new cases. They still haven't reopened schools and I think business restrictions stayed much the same at this point. (also not an island, but cross border traffic is mostly trucking with all borders restricted)

I think the keys are caution, testing, and the ability to respond as new information emerges. One might argue Hokkaido did it right if more was known, but were just a little unfortunate and now need to gear down. Obviously 135 new cases in a week won't overwhelm their health care system.

Compare also to the Province of Quebec, much larger than Hokkaido but comparable population. They are planning to reduce restrictions fairly soon but still have around 800 new cases per day...hopefully not before they have a chance to rethink this, at least for the more urban areas or hot spots.

As Stringy suggested a few posts ago, we're all on a (steep) learning curve, that we'll understand when we've learnt; in the mean time we have learnt from history, we could use it as a basic guide. 

Edited by dimreepr

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Posted (edited)

If the history of cinema is anything to go by, don't ignore the scientists in the opening sequence...

It's a bitter sweet symphony 

Edited by dimreepr

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3 hours ago, J.C.MacSwell said:

5.3 million residents down to 1 or 2 new cases per day does seem reasonable to lift some restrictions. The question would be how much. With just 135 new cases (reported) in a week, hopefully they will make the right adjustments and get back on a more cautious track.

I don't think we will really be able to safely open up to much of a degree anywhere without a number of the right things in place. They may have, but just relaxed restrictions to far, opening up schools and businesses (they don't make it clear to what degree)

In comparison, the province of New Brunswick, with similar land area but about a seventh the population, after over a week of no new cases reduced restrictions almost a week ago and have so far no new cases. They still haven't reopened schools and I think business restrictions stayed much the same at this point. (also not an island, but cross border traffic is mostly trucking with all borders restricted)

I think the keys are caution, testing, and the ability to respond as new information emerges. One might argue Hokkaido did it right if more was known, but were just a little unfortunate and now need to gear down. Obviously 135 new cases in a week won't overwhelm their health care system.

Compare also to the Province of Quebec, much larger than Hokkaido but comparable population. They are planning to reduce restrictions fairly soon but still have around 800 new cases per day...hopefully not before they have a chance to rethink this, at least for the more urban areas or hot spots.

One issue is that Japan is severely undertested. I.e. the number of cases is probably not accurate.

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What then makes the right time to start lifting restrictions - did CharonY suggest that this should be determined by random testing instead of the targeted testing?

It seems to me that number of new cases per day is never an important criteria. It is more important how quickly and effectively a state can micromanage the spread. What do you think?

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Why not both? They’re not mutually exclusive. 

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39 minutes ago, iNow said:

Why not both? They’re not mutually exclusive. 

They are not. But it seems to me that the second always includes the first.

(I am just thinking... to be able to micromanage the spread, the country should probably have one field team of professionals for every case per day. A guestimation.)

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How do you know your management of the spread is or is not working if you fail to measure net new daily cases?

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Yes sure. Any management of the disease heavily relies on prompt and correct measurements. More so if we manage smaller groups.

But the measurement part I don't understand exactly. For example, if you measure antibodies, can you at all conclude anything about spreading rate or direction? I guess one should measure presence of viral particles instead?

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We will never have complete information. We need to strive for as much as we can (and can afford), and tailor our restrictions to our circumstances, to get the balance right.

The risk/reward for this is very asymmetric. We gain very little but time to plan and prepare while holding new cases near zero, but pay dearly if things get out of hand...and we don't really know at what point that can happen. So we have to err on the side of caution...then pay our money, take our chances, and hope for the best. 

Re-opening won't be one size fits all.

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4 hours ago, Danijel Gorupec said:

What then makes the right time to start lifting restrictions - did CharonY suggest that this should be determined by random testing instead of the targeted testing?

It seems to me that number of new cases per day is never an important criteria. It is more important how quickly and effectively a state can micromanage the spread. What do you think?

We cannot have one without the other. Test should not be random either. In the perfect scenario, everyone gets tested and has follow ups. If that is not possible one should prioritize likely cases as it is done in most areas, but it has to ramp up to capture those that may be unknown spreaders. Without that knowledge, containment plans have to be overkill to work, as you do not have a clear view of the spread if your test happens to be biased towards known cases.

In turn that means that we need the ability to ramp up testing capacity as needed (the situation in the US is quite ridiculous, where states are competing with each other in a dystopian bidding war), have a centralized knowledge gathering and distribution system as well as means to conduct contact tracing. There are also specifics to this outbreak that need tweaks in methodology. For example, the worry about asymptomatic spread might need to be addressed via supplementary immunoassays, if direct testing for viral particles cannot be ramped up. 

Again, COVID-19 is one of many outbreak test runs we already had (in this century alone) and the common lesson is that a) we need to improve our response and b) periods of no outbreaks cannot allows us to reduce preparedness. Epidemics and pandemics will keep occurring, it is just a matter of when and where.

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35 minutes ago, CharonY said:

Test should not be random either.

Randomized sets of tests can reveal some information on the spread of the virus that the targeted ones do not.

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7 minutes ago, J.C.MacSwell said:

Randomized sets of tests can reveal some information on the spread of the virus that the targeted ones do not.

To some degree. But unless you have quantitative coverage, you generally want to design your cohort so that they are representative in terms of your research questions (e.g. in terms of age, gender, area etc.).

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Posted (edited)

An opinion piece on the response, successes and failures, of two similar countries, the US and Canada, to the Covid-19 pandemic

https://www.msn.com/en-ca/news/canada/canada-succeeded-on-coronavirus-where-america-failed-why/ar-BB13A2OT?ocid=msedgntp

Makes for interesting reading, and places the large majority of blame, for the US's inadequate response, on its polarized political system, and lack of a universal heath care system.

How many Americans need to die before you Democrats and Republicans learn to work together, and everyone has access to national health care ?
( Oh wait...  Didn't I ask this same question regarding gun control ? )

 

 

Seems even Republicans can't work together...

G W Bush has become the latest target of President D Trump after the former president released a video calling for people and their government to work together.
The President 'slammed' G W Bush, questioning his absence during the impeachment trials.
( Maybe G W was embarrassed to be associated with what passes for presidential behavior today )

Edited by MigL

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20 minutes ago, MigL said:

An opinion piece on the response, successes and failures, of two similar countries, the US and Canada, to the Covid-19 pandemic

https://www.msn.com/en-ca/news/canada/canada-succeeded-on-coronavirus-where-america-failed-why/ar-BB13A2OT?ocid=msedgntp

Makes for interesting reading, and places the large majority of blame, for the US's inadequate response, on its polarized political system, and lack of a universal heath care system.

How many Americans need to die before you Democrats and Republicans learn to work together, and everyone has access to national health care ?
( Oh wait...  Didn't I ask this same question regarding gun control ? )

 

 

Seems even Republicans can't work together...

G W Bush has become the latest target of President D Trump after the former president released a video calling for people and their government to work together.
The President 'slammed' G W Bush, questioning his absence during the impeachment trials.
( Maybe G W was embarrassed to be associated with what passes for presidential behavior today )

In Trumps defence...the current pandemic isn't completely about him...

Where was Bush when it really mattered?

 

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On 4/27/2020 at 8:59 AM, Alex_Krycek said:

People are starving.  People are committing suicide.  Their lives are falling apart before their eyes; in some cases people have worked their entire lives for a business only to see it obliterated by this shutdown.

 

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4 hours ago, iNow said:

 

Straw man.  I never suggested that the previous scenario was a "utopia".  This is a lesser of two evils situation.

If given a choice between earning a living in a stressful environment as opposed to starving to death in anarchy, I would choose the former.  

 

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1 minute ago, Alex_Krycek said:

Straw man.  I never suggested that the previous scenario was a "utopia".  This is a lesser of two evils situation.

Just so we’re clear: I wasn’t setting up a strawman of your position to easily knock down, but was instead referencing your consistent focus on mental health and suicide during hard economic times to set the context for the comment I chose to share. 

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14 minutes ago, iNow said:

Just so we’re clear: I wasn’t setting up a strawman of your position to easily knock down, but was instead referencing your consistent focus on mental health and suicide during hard economic times to set the context for the comment I chose to share. 

Well, I agree with you overall - things need to change in "normal" society. 

I just don't see things improving much when people are under such an increased level of duress.  

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Here is the Province of New Brunswick's, which has one of the most successful responses so far to the pandemic, response plan for reopening in stages. They are about to go to the middle phase (second "opening" phase) after just 2 new cases this week. A week ago they made their first step on re-opening after 2 weeks with no new cases. It's colour coded and can move either way as circumstances change.

ewaonscxsaifpjz.jpg?quality=70&strip=all&w=1200

Also interesting article on how, in part, they managed to avoid the worst of it (so far, and knock on wood) including multi-party cooperation:

https://nationalpost.com/news/canada/heroes-of-the-pandemic-new-brunswick-politician-who-crushed-the-covid-19-curve-is-a-virus-whisperer

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Time for a mention of New Zealand and its coronavirus on this forum...

After 21 deaths and with 65 still active cases it is down to level2 lockdown i.e. just maintain social distancing. The country was put into full lockdown less than a month after the index case.

 https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_New_Zealand

https://www.cnbc.com/2020/05/05/how-new-zealand-brought-new-coronavirus-cases-down-to-zero.html 

 

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57 minutes ago, Carrock said:

Time for a mention of New Zealand and its coronavirus on this forum...

After 21 deaths and with 65 still active cases it is down to level2 lockdown i.e. just maintain social distancing. The country was put into full lockdown less than a month after the index case.

New Zealand is one striking example of a whole class of countries that claim (rightfully) success in fighting the virus. At least they won the initial battle (as I doubt the war is over).

I think, the question is if during that time they managed to establish effective work procedures, organize tracking teams, educate population, increase hospital capacity... If they did, then the initial strong reaction was a good investment. If not, then I they are again at the beginning.... I mean, they cannot remain an island in the ocean forever :)

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I seem to recall there was a plan to have Australia and New Zealand maintain the same restriction zone rather than each country restricting everyone.

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