[Snorlax94]

Thank you all for the information; this thread has been really interesting and useful.

I have some questions I hope you can help me understand: how are the lockdowns going to work (particularly in Italy)? How long will they be in place for? 1 month? 2 months? More? What events or information would trigger a return to normal movement? What would prevent a second surge after normalizing movement? Would that just result in more of these cycles, and a long string of cancelled/postponed events? It seems we are some time away from a vaccine or treatment, so I am wondering about the effectiveness and strategy behind these approaches.

Thanks.

Toroso, 
First, if you are in Italy, my heart goes out to you and your entire country and hope things can improve as soon as possible. 

I think  yours is the question for places like Italy on lock down, and I think it's a side of the equation that I think is under-discussed. I expect flare-ups to recur and recur until there is broad vaccination.  One lock down can halt a current conflagration, but I would expect the disease will come back. Widespread testing may help contain each flare-up, but as the virus rages across the world, cities and countries will keep getting re-infected. 

I do think lock downs will work, and they worked in China. If the problem is that sick people are going out and infecting other people, and some people are sick and don't know it and go out and infect people, if virtually *everyone* is forced to stay at home for 2-3 weeks except for needed workers, food trips and emergencies, that should tremendously decrease the numbers. Let's say there is a town with 50,000 people, 100 people in hospitals, with 200 people sick with symptoms but undiagnosed (some of whom will self-quarantine, some of whom will not) -- and 1000 people who are infected but without symptoms. Normally, many of those 1,200 people would go to concerts, sports events, weddings and infect more people. If you do not permit any events (and close schools) and force most businesses to shutter, those 1,200 people will not infect others. People will stay in their homes until they are better (usually) and no longer infectious. Let's say 90% of the cases are mild. 2-5 weeks later, 1,080 of those 1,200 people may not longer spread the disease, and the 120 who had severe symptoms should be isolated in hospitals. If people strictly follow the quarantine, with a tiny bit of luck, the numbers should be much, much lower after 2-5 weeks.

My concern is that all you've done is hit a "reset" button. The disease is still around. It is still raging in other countries (all over Europe and probably soon in Eastern Europe in Italy's case). So inevitably, Italy will be reinfected again. But the counts will be reduced for now.

This is why I personally think -- and it seems like *everyone* on the Cardboard will disagree with me -- but this is why I think we should be very prudent about shutting down cities. While I think Italy probably should have shut things down earlier, I don't see that it is justifiable in the Bay Area yet. If cities shut things down too early, eventually, people will become cynical and resist future lock downs and it will be harder to enforce them across the country when they are needed.

Eventually, widespread testing will better contain things. And people everywhere hopefully will use this as an opportunity to permanently improve practices like personal hygiene, sanitation, business procedures, social rules, etc., to reduce this and all future viruses. (For example, people *still* apparently think it's OK to go out in the public when they are coughing uncontrollably and clearly sick. Hopefully, the social rules will change.).

A final personal observation -- the data is very, very scant so far, so the real answer to any of this is I don't know and would change any of my positions as new data emerges. But the tiny bit of information that's been revealed about the spread of the sickness has tended to be by older people. Like the super-super spreader in the South Korean church. Or the assisted living center in Washington. Even with the super-spreading in New York, Governor Cuomo in an interview said there were a few instances where hundreds of people convened "for celebrations," and it is at this celebrations that the virus spread. It sounds like weddings, or religious gatherings, and probably not schools or sports. I am not aware of any data from any super spreading cases where children were spreading the disease, which I find remarkable (to my knowledge, no classroom has ever been traced as a source of major transmission). So personally, I lean that governments should be more pro-active about places where the elderly gather -- senior centers, churches, hospitals, weddings (even in my experience, Stanford athletics events), because from what I have seen thus far, not only are the elderly much more likely to experience complications, they are much more likely to be spreaders (which would make sense, as people who are overwhelmed by sickness are more likely to shed virus everywhere). This may also be what has made things so severe in Italy, due to the demographics in that country.

These are my opinions, and probably a minority viewpoint on this bulletin board, but others will express theirs. I hope others will provide their opinion and respond to Tosoro's question.

[Snorlax94]

Thank you all for the information; this thread has been really interesting and useful.

I have some questions I hope you can help me understand: how are the lockdowns going to work (particularly in Italy)? How long will they be in place for? 1 month? 2 months? More? What events or information would trigger a return to normal movement? What would prevent a second surge after normalizing movement? Would that just result in more of these cycles, and a long string of cancelled/postponed events? It seems we are some time away from a vaccine or treatment, so I am wondering about the effectiveness and strategy behind these approaches.

Thanks.

Toroso, 
First, if you are in Italy, my heart goes out to you and your entire country and hope things can improve as soon as possible. 

I think  yours is the question for places like Italy on lock down, and I think it's a side of the equation that I think is under-discussed. I expect flare-ups to recur and recur until there is broad vaccination.  One lock down can halt a current conflagration, but I would expect the disease will come back. Widespread testing may help contain each flare-up, but as the virus rages across the world, cities and countries will keep getting re-infected. 

I do think lock downs will work, and they worked in China. If the problem is that sick people are going out and infecting other people, and some people are sick and don't know it and go out and infect people, if virtually *everyone* is forced to stay at home for 2-3 weeks except for needed workers, food trips and emergencies, that should tremendously decrease the numbers. Let's say there is a town with 50,000 people, 100 people in hospitals, with 200 people sick with symptoms but undiagnosed (some of whom will self-quarantine, some of whom will not) -- and 1000 people who are infected but without symptoms. Normally, many of those 1,200 people would go to concerts, sports events, weddings and infect more people. If you do not permit any events (and close schools) and force most businesses to shutter, those 1,200 people will not infect others. People will stay in their homes until they are better (usually) and no longer infectious. Let's say 90% of the cases are mild. 2-5 weeks later, 1,080 of those 1,200 people may not longer spread the disease, and the 120 who had severe symptoms should be isolated in hospitals. If people strictly follow the quarantine, with a tiny bit of luck, the numbers should be much, much lower after 2-5 weeks.

My concern is that all you've done is hit a "reset" button. The disease is still around. It is still raging in other countries (all over Europe and probably soon in Eastern Europe in Italy's case). So inevitably, Italy will be reinfected again. But the counts will be reduced for now.

This is why I personally think -- and it seems like *everyone* on the Cardboard will disagree with me -- but this is why I think we should be very prudent about shutting down cities. While I think Italy probably should have shut things down earlier, I don't see that it is justifiable in the Bay Area yet. If cities shut things down too early, eventually, people will become cynical and resist future lock downs and it will be harder to enforce them across the country when they are needed.

Eventually, widespread testing will better contain things. And people everywhere hopefully will use this as an opportunity to permanently improve practices like personal hygiene, sanitation, business procedures, social rules, etc., to reduce this and all future viruses. (For example, people *still* apparently think it's OK to go out in the public when they are coughing uncontrollably and clearly sick. Hopefully, the social rules will change.).

A final personal observation -- the data is very, very scant so far, so the real answer to any of this is I don't know and would change any of my positions as new data emerges. But the tiny bit of information that's been revealed about the spread of the sickness has tended to be by older people. Like the super-super spreader in the South Korean church. Or the assisted living center in Washington. Even with the super-spreading in New York, Governor Cuomo in an interview said there were a few instances where hundreds of people convened "for celebrations," and it is at this celebrations that the virus spread. It sounds like weddings, or religious gatherings, and probably not schools or sports. I am not aware of any data from any super spreading cases where children were spreading the disease, which I find remarkable (to my knowledge, no classroom has ever been traced as a source of major transmission). So personally, I lean that governments should be more pro-active about places where the elderly gather -- senior centers, churches, hospitals, weddings (even in my experience, Stanford athletics events), because from what I have seen thus far, not only are the elderly much more likely to experience complications, they are much more likely to be spreaders (which would make sense, as people who are overwhelmed by sickness are more likely to shed virus everywhere). This may also be what has made things so severe in Italy, due to the demographics in that country.

These are my opinions, and probably a minority viewpoint on this bulletin board, but others will express theirs. I hope others will provide their opinion and respond to Tosoro's question.