Rethinking the Lockdown
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Remember Dr. Makary?
We talked about him on the old platform back in March.
Months ago, I called for a long lockdown. Now we must minimize collateral damage.
In late February, as data on the coronavirus pandemic continued to unfold, I started making calls to friends and family to prepare them. I told them to get ready to hunker down for three months. For many then, it was hard to believe that a virus we couldn’t much see evidence of, less understand, would require us to shut down our economy.
I also spoke with C.E.O.s and governors, urging them to close nonessential businesses and enact stay-at-home orders to stop the spread of the virus. Other public health advocates called for the same — and fortunately government and business leaders responded. Their actions saved hundreds of thousands, if not millions, of lives and spared American hospitals the horrors of rationing care. Shutting down was the right policy at the time.
As circumstances have evolved, so has my thinking. We have survived the surge in hospitalized cases and suffered immense economic trauma. The full lockdown made sense weeks ago. But the situation is changing, and more data on the virus are now available to inform our next steps. The choice before us isn’t to fully lock down or to totally reopen. Many argue as though those are the only options.
As a physician, I firmly believe that the primary goal of our reopening strategy should be to maximize the number of lives saved. But virus mitigation can take many forms, ranging from effective to excessive. Extreme forms of mitigation can have diminishing returns. Projections of the death toll produced by the current economic shutdown are often politically motivated, but the effects on human life are real.
In late April, the United Nations World Food Program reported that 250 million people may face starvation as a result of the economic impact of Covid-19. In America, local food banks are already congested with record wait times. There are other serious consequences of continuing stay-at-home orders and prolonging economic disruption. Deferred medical care, mental health problems, domestic violence and one of the biggest pre-Covid-19 public health problems in the United States — loneliness — are all magnified by in-home sheltering. The economic and public health harm associated with sheltering is yet to be fully measured.
Debatable: Agree to disagree, or disagree better? Broaden your perspective with sharp arguments on the most pressing issues of the week.
At the same time, the coronavirus will persist. We must take proper care in how we reopen, lest we discount human life in the race to prosper. That would worsen already troubling trends, given that Covid-19 disproportionately affects disadvantaged communities dependent on public transit and in congested living conditions. Our path to reopen should protect those at high risk. The current “normal,” with its economic anxiety, skyrocketing unemployment and social isolation, can’t carry on — we should work toward a new status quo until there’s an available, mass-produced therapeutic.So what does a new, safer status quo look like? It looks different in different parts of the country. Not all reopenings are created equal. Areas with continuing outbreaks or rising cases should postpone nonessential activity, and those with a declining case trend should engage in some basic practices.
Read it all.
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I heard an idiot on CBS News this morning, pushing an Administration health officials in why the Feds didn't institute unilateral opening strategies. The simple reason is that governors know what is happening within their state, better than the Feds.
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Our culture isn't even willing to do this.
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No, people are tired of the lockdown and if grandma has to go...Well, goodbye grandma...
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80% of Americans are for a safe, careful reopening. The rest are belligerent assholes. A lot of them live near me, some are people I have known all my life. They talk a lot about being wolves and everyone else sheep, but in fact they are the sheep. Wolves aren't much good against a virus.
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@Mik said in Rethinking the Lockdown:
80% of Americans are for a safe, careful reopening.
Which is impossible to define.
At least it is impossible to define in a way that can be implemented and demonstrate any sort of measurable results.
I think a large number of people will still stay home or limit activity, whether the states are reopened or not.
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@Copper said in Rethinking the Lockdown:
At least it is impossible to define in a way that can be implemented and demonstrate any sort of measurable results.
What you mean to say is that there's no counterfactual. Outside of scientific systems and engineering problems - you can't really get measurable hard data after you do something - that is exactly attributable to the thing you did.
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Starting a new business
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Managing a large organization
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Political policy
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Etc.
Striving for a "safe, careful opening" is as realistic or futile (depending on your POV) as striving for a sound business plan before launching a product, or hiring a competent CEO or setting deliberate tax policy.
You'll never get hard data on what exactly your policy or action did - because you can't separate from the myriad other variables at play.
Still - we task our "best and brightest" with these problems.
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@Mik said in Rethinking the Lockdown:
It's being defined every day in every state. Measurable results is that new infections and hospitalizations don't spike. See how easy that was?
Measurable results also include barbers and plumbers and carpenters and restaurant owners loosing businesses that they have spent their lives building.
To top it off they are being called reckless for wanting to reopen.
There are at least two sides to this.
If it was up to me I would shutdown everything, roads, hospitals, police, fire, electricity, water, everything. Shut it all down for 2 weeks make everyone stay indoors and get it over with. Then open it all back up.
After that let people make their choices, come out or stay home.
This process of management by emotional outburst isn't doing anyone any good.
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@Copper said in Rethinking the Lockdown:
If it was up to me I would shutdown everything, roads, hospitals, police, fire, electricity, water, everything. Shut it all down for 2 weeks make everyone stay indoors and get it over with. Then open it all back up.
That's a good idea. Everyone prepare for two weeks of complete isolation, hunker down in place. I wonder if this would work, in terms of getting rid of the virus.
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Maybe, but since people won't do it, no.
I think the South is going to do better than some other parts of the U.S., mostly because we're going into that part of the year with really hot temps and really high humidity. Our virus friend does not like heat and humidity.
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It would take 4-5 weeks at least and would have to be the entire world. Tell me how that goes.
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@xenon said in Rethinking the Lockdown:
@Copper said in Rethinking the Lockdown:
Thanks so much for telling me what I mean to say.
You're welcome. It was a polite way of saying you probably don't agree with your own statement.
Do you know what the word polite means?
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@Copper said in Rethinking the Lockdown:
@xenon said in Rethinking the Lockdown:
@Copper said in Rethinking the Lockdown:
Thanks so much for telling me what I mean to say.
You're welcome. It was a polite way of saying you probably don't agree with your own statement.
Do you know what the word polite means?
Yes. The previous post was not polite. The one before it was.
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@Jolly said in Rethinking the Lockdown:
Maybe, but since people won't do it, no.
I think the South is going to do better than some other parts of the U.S., mostly because we're going into that part of the year with really hot temps and really high humidity. Our virus friend does not like heat and humidity.
Also lower population density down there. Which should help.
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Also Vitamin D, and you guys take a bunch of Pepcid AC thanks to all that Jambalaya...