COVID-19 Shutdown Exit Strategy?

[copyright1997reloaded]

As we all debate all this this economy vs. saving lives and preventing illness, we need to keep one thing in mind.

Most will eventually get this virus. The only thing we need to do is ensure our ability to care for those who get it at any point in time is not exceeded by the number that have it at that point in time.

So besides economic quarantine we can bend the other curve more. The ability to prevent (masks and sanitizers), track (test kits easy and quick), and care (respirators); for everyone who wants / needs it.

Want to restart the economy? A manhattan project for production of these items will allow the population to return to work with the confidence that should they fall ill, they will know it and care will be available.

So while congress debates $2T in economic relief. Where is a simple $100B (guess) for this manhattan project?

Here's a wild, no facts opinion: In two months we will be awash in masks, ventilators, hand sanitizer, gloves, and ... toilet paper.

Let's take hand sanitzer as an example: This is not the same is producing an atomic bomb (since you mentioned the Manhattan project). Distillers and others (e.g. ABev) have already started making it. Even *I* could make it given the ability to make Alcohol (from grains).

Probably the toughest one to ramp up is ventilators, at least fancy computer controlled ones. But even that isn't new, unknown technology - the Iron Lung was created in 1928 (and that is what a respirator is when you get under the covers). Some headlines in the past 24 hours:
Ford working with 3M and GE to make ventilators: https://www.cnn.com/2020/03/24/business/ford-3m-ge-ventilators-coronavirus-duplicate-2/index.html

FDA eases rules on ventilator makers: https://www.medtechdive.com/news/coronavirus-fda-relaxes-rules-on-ventilator-manufacturers/574648/

and so on...

 

[Midpack]

Here's a wild, no facts opinion: In two months we will be awash in masks, ventilators, hand sanitizer, gloves, and ... toilet paper.

Of course, not exactly profound. Supply will rise but can’t meet demand immediately. Eventually stepped up production will satisfy remaining demand. Then demand will decline, and production will revert to previous or new norm. That’s how it’s always worked.

It’s silly some people expect supply to be able to instantly increase 10x, 100x or more in response to a spike, but clearly many do. For any given product, raw materials, production equipment, employees and all are scaled to match normal demand. Manufacturers can’t instantly add any of those elements, especially knowing the demand will revert to norm soon after.

For example, existing mask manufacturers will maximize production and other manufacturers who already have employees, materials and equipment that can be easily converted to masks will do so. But that’s not likely to yield 10x, 100x or more.

That’s why the immediate effort to stem the rate of infections, mask supply can’t possible rise exponentially. And as health care providers get infected, the problem compounds. Rough situation.

Same for all other products in high demand.

 

[Which Roger]

We will continually progress to where we can improve one without negatively impacting the other. Data patterns will emerge. We will understand the disease better including who might be immune to the virus and why some people will not develop symptoms. We will understand how it is and is not transmitted. We will understand all kinds of other things that will allow us to make progress toward getting life back to normal while at the same time reducing the impact of the virus.

 

[PatrickA5]

So today the president mentioned an exit strategy ""WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF. AT THE END OF THE 15 DAY PERIOD, WE WILL MAKE A DECISION AS TO WHICH WAY WE WANT TO GO!". Andrew Cuomo (Governor of NY) stated: "I take total responsibility for shutting off the economy in terms of nonessential workers, but we also have to start to plan the pivot back to economic functionality. You can’t stop the economy forever,”

So this (well Trump's statement at least - the fact the Cuomo also stated something similar seems to be ignored) has started a "twitter storm" with the hash tag #NotDying4WallStreet.

Not wanting to debate politics here - or -who said what -- but I wonder if most of the people out there today realize/don't realize what will happen to them (not just Wall Street) if the economy is significantly shut down for a long period of time.

I imagine the President is itching to get the economy going again, but I don't think just him saying the economy is "now open" is going to change anything. The individual states/cities are basically making the call on what to do based on what they are seeing in their communities.

 

[Toocold]

Probably the toughest one to ramp up is ventilators, at least fancy computer controlled ones.

People want the government to force our manufacturers to make equipment. I like Elon Musk's approach:

"Tesla CEO Elon Musk said on Twitter that the California-based automaker bought hospital ventilators in China and shipped them to the United States. The purchase comes as governments across the globe, including here in the U.S., appeal to automakers and aerospace companies help procure or make ventilators and other medical equipment.

Elon Musk@elonmusk
Yup, China had an oversupply, so we bought 1255 FDA-approved ResMed, Philips & Medtronic ventilators on Friday night & airshipped them to LA. If you want a free ventilator installed, please let us know!"

 

[Midpack]

I imagine the President is itching to get the economy going again, but I don't think just him saying the economy is "now open" is going to change anything. The individual states/cities are basically making the call on what to do based on what they are seeing in their communities.

I think Cuomo actually said it first. Governments revenues are dropping like a rock and they have employees to pay too. Lots of people are going to get desperate quickly, and it will snowball. States/cities are going to have to balance the cure versus the illness too. Once a few states make the move, others will follow - just as they all followed into lockdowns and guidance.

China and South Korea are getting back to work.

We can’t function indefinitely without an underlying economy.

 

[daylatedollarshort]

It's called immunity. If you are immune, you won't get it. For those who get it but are asymptomatic, who knows? Most likely it is a genetic anomaly. Luck of the draw. It would be exceedingly rare to have some sort of 'lifestyle' choice cause one to develop immunity to viruses. That's not how viruses work.

If it worked and was easier, it would be done. You think overcrowded hospitals are choosing the intensive ventilator path instead of just handing out vitamins because they like it? Same for Bredesen. If his plan worked, the Alzheimer's wards would be nearly empty. People don't generally avoid cures that actually work...

I'm not personally an expert in debate or the shortcomings of modern medicine. But if you are open to considering an entirely different perspective, you might be interested in checking out the evidence based videos or books by Bredesen, nutritionfacts.org and William Li. The best is probably How Not to Die by Dr. Greger of nutritionfacts.org.

 

[Chuckanut]

Chuck, Tennessee and Virginia. I don’t think realistically any will try to open.

Interesting. Thanks.

Our state school super indent has stated that the districts must continue to instruct in some way. They just can't close and say 'See you in September'. What that will look like is really up to them.

Another problem is teacher pay. State law does not allow paying public employees who do not work. That is called "making a gift of public funds" and is a big NO NO. So I assume the teachers will be doing things like sending out packets of work to do and grading them.

What a mess!

 

[Chuckanut]

Well, we have the President and Gov. Cuomo both saying the business shutdown can't go on very long unless the cure becomes worse than the disease. I am glad this issue is coming forward.

So, it seems it's time that the medical experts start considering what we need to do to get people and the economy working again.

I was listening to some news 'personalities' pooh-pooh the idea, but I imagine most of them could not earn another dollar for the rest of their lives and still live far better than the average American/Canadian/European. Talk about a bubble.

 

[daylatedollarshort]

Really, nah. If you believe that the health pros looking into solving a global health pandemic are not looking at freaking every possibility of cause, for treatment, and for prevention, then your opinion of all these teams is far less than mine. I have zero doubt that there are smart doctors and researchers looking at everything. Of course, different groups are targeting their area of expertise, but I do not think there are stones being left un-turned. Not this time.

You might find the Ask Me Anything on Reddit today of interest:
"There is an appalling lack of coordinated crowd-based (or self-reported) data collection initiatives related to COVID-19. Currently, if coronavirus tests are negative, there is no mandatory reporting to the CDC...meaning many valuable datapoints are going uncollected"

Source: https://www.reddit.com/r/IAmA/comments/fo4gc5/im_phd_pharmacologist_immunologist_and/

 

[Which Roger]

You might find the Ask Me Anything on Reddit today of interest:
"There is an appalling lack of coordinated crowd-based (or self-reported) data collection initiatives related to COVID-19. Currently, if coronavirus tests are negative, there is no mandatory reporting to the CDC...meaning many valuable datapoints are going uncollected"

Source: https://www.reddit.com/r/IAmA/comments/fo4gc5/im_phd_pharmacologist_immunologist_and/

I see a lot of parallels between now and the days following Pearl Harbor. Chaos at first, but we quickly got our act together an achieved more than anybody could have possibly imagined.

 

[Independent]

I can't see a sudden restart. Every state/city will be on its own trajectory.

Gradual measures make sense to me. Instead of no indoor seating in restaurants, it will be counter service only, with half the tables marked "not available", and disinfecting wipes/spray on every table. That will feel like progress.

Offices may go to 20% of staffers can work in the building on Monday, a different 20% on Tuesday, etc.

You can drive to work, but the public transportation is still down.

We'll feel better because there is movement, even though we're a long way from normal.

Major progress depends on massive rollouts of an antibody test that can tell people they are immune. Note that Cuomo specifically said he wants to try tests as soon as possible.

 

[ERD50]

It's called immunity. If you are immune, you won't get it. For those who get it but are asymptomatic, who knows? Most likely it is a genetic anomaly. Luck of the draw. It would be exceedingly rare to have some sort of 'lifestyle' choice cause one to develop immunity to viruses. That's not how viruses work. ...

I'd bet (will try to find some sources later), that it has a lot to do with how much of the virus an individual gets hit with at once.

A small amount from a surface, that's probably weakened from being away from its host person, and another person touches their eye after touching that surface? A healthy person's immune system probably makes quick work of that very small amount, w/o any outward signs at all (remember, we are fighting the germs that are all around us 24/7). But an infected person coughs, and you are within 3 feet and end up inhaling many droplets of 'fresh/active' virus? That's a horse of a different color, I would think.

... If it worked and was easier, it would be done. You think overcrowded hospitals are choosing the intensive ventilator path instead of just handing out vitamins because they like it? Same for Bredesen. If his plan worked, the Alzheimer's wards would be nearly empty. People don't generally avoid cures that actually work...

Yep. A friend of mine would go on about the anecdotal evidence of a bunch of what I considered wacky cures/treatments. I kept telling him, I won't dismiss the anecdotes out of hand, but if they are as powerful as you say, surely there must be some double blind testing that confirms this. But I could never find it. Why not?

Sometimes we don't understand how something works, so I won't reject an idea on that basis (though no clear 'how' does increase the skepticism a bit). But data should show us that it does or doesn't work.

-ERD50

 

[Nemo2]

Yep. A friend of mine would go on about the anecdotal evidence of a bunch of what I considered wacky cures/treatments.

A buddy of mine, who's always been somewhat 'out there', recently forwarded a 'comprehensive list' of (mumbo jumbo cures) 'treatments'.......I glanced down as far as the exhortation to tap one's wrist against a tabletop numerous times in order to release/activate 'electronic impulses' or somesuch, which would......(that's as far as I got).

 

[GTFan]

So now I'm thinking that the "15 days to slow the spread" that the Covid-19 task force is recommending might lead to the exit strategy. After 15 days (8 days from now I think, so starting April 1) if the infection/mortality curves have started to slow Dr. Fauci can begin relaxing some of the recommendation. Especially things like applying social distancing to businesses.

So instead of recommending "avoid eating or drinking in bars, restaurants..." the next 15 days should say "eat in restaurants that practice social distancing (tables 6 feet apart) and enhanced hygiene". And instead of "Avoid discretionary travel, shopping trips, and social visits" they could recommend "practice social distancing, and patronize businesses that do". Lastly, wider availability of surgical and N95 masks in a week or two might lead to a recommendation for, say, restaurant servers to wear masks.

I think that Federal leadership, based on bending the curves, might give the Governors and Mayors the cover they need to dig themselves out of the hole they have dug.

Or as others have pointed out, they will have decided to cut their losses and move on to avoid wrecking the economy. Tell the sick/elderly/at-risk to stay home and let everyone else go about their business. Accept that we have to just get over and it and move on knowing that that vast majority will survive it.

Will be interesting to see if hospitals getting overrun changes that calculus.

 

[statsman]

Or as others have pointed out, they will have decided to cut their losses and move on to avoid wrecking the economy. Tell the sick/elderly/at-risk to stay home and let everyone else go about their business. Accept that we have to just get over and it and move on knowing that that vast majority will survive it.

Will be interesting to see if hospitals getting overrun changes that calculus.

That's probably where we are headed, and yeah, medical and hospital services are the long pole in the tent. If any of the known and discussed drugs start proving effective in treating the virus, we will likely accelerate the process as you have laid out.

 

[RetiredAt55.5]

A sudden start of the economy, at this time, could be a disaster.

The Washington Post had an article today about Italy's situation.

This was unsettling to me -

"Neither is the crisis in Italy a product of an especially feeble health system. Italy has fewer acute-care beds relative to its population than South Korea or Germany, but more than Britain or the United States. The death toll is being intensified by breakdowns at hospitals, but the strains are the same as could happen anywhere in the developed world that sees such a surge in coronavirus cases."

I'm sure everyone's seen the pictures of Italy's sick patients lying in the hospital hallways.

 

[Midpack]

A sudden start of the economy, at this time, could be a disaster.

The Washington Post had an article today about Italy's situation.

This was unsettling to me -

"Neither is the crisis in Italy a product of an especially feeble health system. Italy has fewer acute-care beds relative to its population than South Korea or Germany, but more than Britain or the United States. The death toll is being intensified by breakdowns at hospitals, but the strains are the same as could happen anywhere in the developed world that sees such a surge in coronavirus cases."

I'm sure everyone's seen the pictures of Italy's sick patients lying in the hospital hallways.

All true. And I’m not discounting any of it.

But we’re going to have to ease back into economic activity at some point, and we can’t wait until Coronavirus has been completely eradicated. More people will die than ideal, or we’ll have a depression so deep it’ll take a generation or more to recover from. People are going to suffer mightily coming out of this, financially and unintended health consequences. I may be dead wrong, but the longer we’re shutdown, the less likely (if at all) the economy will bounce back quickly. A long, slow, painful recovery - as bad as post 2009 - seems more likely to me. Hope I’m wrong.

No easy answers, no black or white. There will be critics no matter what. I think Cuomo is on the right track, not too soon to think about the other side while managing today at the same time.

 

[PatrickA5]

Or as others have pointed out, they will have decided to cut their losses and move on to avoid wrecking the economy. Tell the sick/elderly/at-risk to stay home and let everyone else go about their business. Accept that we have to just get over and it and move on knowing that that vast majority will survive it.

I think that's where we're headed. Restart the economy and let the old folks fend for themselves.

The fact the President brought up deaths from car wrecks and the flu last night leads me to believe he's aiming to turn the economy back on sooner rather than later. The states and cities might see things differently though.

 

[REWahoo]

I may be dead [-]wrong[/-], but...

FIFY

 

[Freedom56]

I would see a phased opening like they are doing in China for those states that have effectively shut down in about 2-3 weeks. Then it will become a case by case isolation and tracking problem.

Those cities that have not shut down, may be in for some trouble. Particularly where there is a high incidence of obesity which can cause obstructive breathing. Letting those locations take the virus head on is not a wise public health policy.

In any case, the economy will not come back until the rest of the world starts opening up for business again. The damage have been done to the travel industry which will take time to repair. I can't see too many people jumping on to cruises unless they start doing medical testing before boarding (which would be a good thing).

But in a few years much of this will have been forgotten, and Hollywood will be making movies or even a series about it.

 

[gwraigty]

So today the president mentioned an exit strategy ""WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF. AT THE END OF THE 15 DAY PERIOD, WE WILL MAKE A DECISION AS TO WHICH WAY WE WANT TO GO!". Andrew Cuomo (Governor of NY) stated: "I take total responsibility for shutting off the economy in terms of nonessential workers, but we also have to start to plan the pivot back to economic functionality. You can’t stop the economy forever,”

So this (well Trump's statement at least - the fact the Cuomo also stated something similar seems to be ignored) has started a "twitter storm" with the hash tag #NotDying4WallStreet.

Not wanting to debate politics here - or -who said what -- but I wonder if most of the people out there today realize/don't realize what will happen to them (not just Wall Street) if the economy is significantly shut down for a long period of time.

+1

 

[fh2000]

A sudden start of the economy, at this time, could be a disaster.

The Washington Post had an article today about Italy's situation.

This was unsettling to me -

"Neither is the crisis in Italy a product of an especially feeble health system. Italy has fewer acute-care beds relative to its population than South Korea or Germany, but more than Britain or the United States. The death toll is being intensified by breakdowns at hospitals, but the strains are the same as could happen anywhere in the developed world that sees such a surge in coronavirus cases."

I'm sure everyone's seen the pictures of Italy's sick patients lying in the hospital hallways.

You mean, this video from youtube?

It is from Spain, another hard hit country.

 

[PatrickA5]

I think that's where we're headed. Restart the economy and let the old folks fend for themselves.

The fact the President brought up deaths from car wrecks and the flu last night leads me to believe he's aiming to turn the economy back on sooner rather than later. The states and cities might see things differently though.

The President said on FOX that he'd love to have the economy opened up by Easter. We'll see.

 

[gwraigty]

I think Cuomo actually said it first. Governments revenues are dropping like a rock and they have employees to pay too. Lots of people are going to get desperate quickly, and it will snowball. States/cities are going to have to balance the cure versus the illness too. Once a few states make the move, others will follow - just as they all followed into lockdowns and guidance.

China and South Korea are getting back to work.

We can’t function indefinitely without an underlying economy.

+1