Unfortunately yes. Even if one wants to keep the quarantine at all costs, it should be a political decision, not only medical, after weighing everything.

In Italy, where I'm in my third week being shut in, experts and doctors are being quoted tiredlessly by the news: the problem is that they're doing their job (which is good!) however they do not realize the impact of their suggested measures. Not their fault by any means, but:

a. They're effectively scaring the population (an WHO advisor here suggested 6-9 months lockdown, which is likely impractical and will have devastating consequences on the social fabric, even without thinking about the economy)

b. The politicians are so scared of the virus that they're completely abdicating their functions (in Italy the Parliament was closed for two weeks, and the judicial system has been completely shut down as well) and doing whatever they're being told.

The fact is this is a good pandemic to practice on. We are very very lucky, to even be debating the economy right now.

If this virus was far deadlier and affected young people, I think the tone on this very site would change in a heartbeat.

Agreed. It's the same reason why I think we'll learn essentially nothing from it and be back to business-as-usual (with poor safety net and tiny stockpile of medical essentials) in just a couple years.

My hope is that after this pandemic (assuming it slows down or we gain control over it), governments around the world will enact policies that prepare us for future pandemics. Like a postmortem type of thing where they document what went wrong, what could be done better, and what they can do to mitigate the impacts of future pandemics, in a rational and blameless manner.

Similar to what happened after the financial crisis with additional financial regulation.

I have no doubt another pandemic will happen, and we'll likely have forgotten what it's like, so having policies in place becomes even more important.

> Similar to what happened after the financial crisis with additional financial regulation.

But that's only temporary.

It's like developers starting over and promising themselves that they won't accrue technical debt this time. And then life happens and you need to push that feature quickly and a few years down the line, you're sitting there saying "we need to start over, this is too much trash held together by hopes and dreams".

Companies will cut corners, because that's their main focus. Politicians will reduce regulations, because that's how they stimulate locale economy, and we're back at square one in no time.

The only lasting shift, aside from potentially more work from home, is people making sure they'll always have an extra package of toilet paper. They won't flee the cities (where viruses can spread much better), even though the rent is killing them, and they won't go into voluntary lock down the next time a thousand people die in China of some lung disease.

A lot of things come with heavy costs - the US military is funded billions upon billions year after year for a threat that may never come. The wars in Iraq and Afghanistan probably at this point are more costly than the bailout we are giving to the economy.

In fact, most of the hard problems the world faces will require investments that take longer than 10 years to return on.

The economy is important - but maybe our economy needs to be a little less growth oriented and a little more resilient.

The US military isn't funded to respond to potential threats, it's funded to be a threat. It's like Google giving Android away, they'll make that money back multiple times on other deals.

> The economy is important - but maybe our economy needs to be a little less growth oriented and a little more resilient.

I absolutely agree, but I also believe that's not going to happen. And it's not because there's some cabal that won't let it, it's just that everybody wants more and I don't see that changing. Our economic setup with the constant demand for growth is just the result of that. I don't believe you can put the genie back in the bottle, few people are at a point in life where they'd be happy to stay at that level for the rest of their days.

> The US military isn't funded to respond to potential threats, it's funded to be a threat.

This is pointless, circular logic. It is funded to be a threat to defend its interests, from threats, that may never materialize.

It will change in the right circumstances. We may be closer to them than most think.

The point of being the guy with the largest stick is primarily that everybody has to do what you say. A secondary function that emerges after you do that is to ensure that those with the smaller sticks don't gang up on you and pay you back. My point is that "defend its interest" isn't it, it's "advance its interest". The US wouldn't be where they are today if there was no military on earth, their huge success is based on the military being there to bully other countries to comply with political demands, or to simply regime change if they don't.

That sure might change, and it won't be pretty for US citizens, but it will be great for plenty of countries. Until they get under China's rule, of course.

Isn't Italy in a pretty bad shape to restart the virus spread right now?

As soon as the government can detect a 16-times increase in the number of cases, act, and still be soon enough for the next 200-times increase not to be a tragedy, it is a good time to leave the quarantine. Right now Italy can't stand the first increase.

The good news is that each time the disease spreads, those numbers become smaller, the bad news is that we don't know by how much.

> Isn't Italy in a pretty bad shape to restart the virus spread right now?

It won't be able to hold a long-standing quarantine. Probably a couple of months tops. That's not even mentioning the economy. As I said, endured isolation will have very bad side effects.

You know, after a short search and calculation, it looks like today there are about 4 times more people dying in your country than usual. That's pretty big. In a couple of weeks, there will probably be nearly no new cases, so you can detect growth without it immediately being a disaster.

Yes, there are economic consequences, but the alternative is quite a lot of avoidable deaths.

I think this is a false choice.

As Bill gates said, we can't say- "Hey, keep going to restaurants, go buy new houses, ignore that pile of bodies over in the corner. We want you to keep spending because there’s maybe a politician who thinks GDP growth is all that counts"

The truth is that it seems our choice is relatively simple:

1) Allow the virus to spread rapidly, overload the health system, kill many people, until herd immunity is reached.

2)Do partial shut down measures, some partial efforts at testing and contact tracing, let the virus continue for a long time, and more slowly reach option 1.

3)Do strong shut down measures until the virus is able to be controlled by a strong testing+contact tracing regime.

Iran (seems to have?) chosen option 1.

Italy started with option 2, and will hopefully move into option 3.

Option 3 is the only acceptable option that doesn't destroy the economy and health systems.

Unchecked, 10 cases of this virus will turn into 100s of thousands. That is the same with 10 cases in March, or 10 cases in May or 10 cases in any month.

People just dont get exponentials. They don't understand that if you get a total of a million cases in a week's time, most of those cases appear on day 6. They can't see how 1/7th of those cases turns into a million. Every country should be hoping that whoever calls the shots understands math.

People just don’t get sigmoids. They don’t understand that herd immunity quickly starts to slow the local spread of a virus in a region, and that you can’t model the entire population of a country like bouncy balls in a box. Every country should be hoping that whomever calls the shots understands math better than the average HN commenter.

This might be a logistic curve in the long term. But if this runs wild it will look like an exponential for a while longer. If your doubling time is 3 and a bit days. You can't just sit back saying "the inflexion point is coming any day now!". You need to do something yesterday.

> ignore that pile of bodies over in the corner.

“That pile of bodies” is mainly the elderly and terminally ill, demographics that society already seems to have little problem ignoring. Even now the worry among most of the population seems to be that those demographics will overwhelm the health system, preventing everyone else from getting medical attention. But this could be solved by triaging, which is rumoured to already be the de facto standard in Italy (i.e. if you are over 60 and show coronavirus symptoms, other patients take priority over you).

The longer the lockdowns in various countries go on, the stronger I think societal pressure for solution 1) – with triaging to avoid overloading the health system – is going to get.

Still enough normal 30-49 olds are dying as well

You can also collect data on the risk groups during the current shutdown period, provide the infrastructure for isolating the risk groups (ie. setup delivery services, organise isolated accommodation, etc.), triage appropriately in the case of spikes and then transition in to plan 2.

Considering the numbers of infected people confirmed alone and the percentage of asymptomatic cases contact tracing and testing sounds about as realistic as waiting on a cure.

There's no guarantee that option 3 can be accomplished in the US. We might aim for it and realize that we're only accomplishing #2 and now inflicted maximum economic damage on top of it.

I think it's a fair discussion to take, but how are you going to run an economy with the health service in permanent overload?

That is what would happen if you just let the thing pass. Those charts of "squashing the sombrero" have the number of beds at a very low place compared to the expected hump of cases. On some of them you can barely even see the gap between the red line and the zero line, due to the scale of the hump.

Death rates would shoot up way above what is normal for the disease, people would die of all sorts of other preventable things too.

Already everyone I know who was going to get a preventative health diagnostic test (myself included) in the next two months has had the test rescheduled. Otherwise healthy people are likely to have some percentage of un-diagnosed issues go on an extra month or two because of this, so it's definitely not just those who are directly infected with Coronavirus.

Some places' ERs are already at capacity, and there's no way I would go to one right now unless I was almost at death's doorstep. That's not necessarily a good thing if something happens that should normally require an ER visit.

Also, some procedures being performed that a patient would normally stay overnight and be monitored are being changed to outpatient. It can now be more risky to stay in a hospital than it is to go home for recovery, even though you can't be monitored for potential post-procedure complications.

It seems to me that the health care system in general is one institution that has shown severe signs of strain in this crisis, and perhaps will need to be rethought along with others.

Interestingly enough, questioning the health of that particular institution is much more taboo than most in this crisis. Given the practical importance of patient faith in the healthcare provider that may be reasonable, but for my money I'd like to be able to try and imagine a better healthcare system in a public forum without getting downvoted for criticizing its current incarnation.

> thow are you going to run an economy with the health service in permanent overload?

You start rapidly building additional capacity to handle the load.

Ok not permanent as in years and years. But long enough that it's towards the end of the year before there's capacity.

You don't want people dying needlessly for half a year.

And while the overload is on, the economy will be affected, whatever the response is.

Doctors have passed from the illness, too. Even young, healthy ones. Stress and lack of sleep hurt the immune system.

I wonder how much the viral load affects this? People working in these conditions are at a high risk of inhaling a large amount of virus at different times.

I believe this was linked somewhere else on HN. It sounds like this is one of the possible causes of doctors being more affected by the virus, but they don't know for sure.

https://www.cnn.com/2020/03/16/health/doctors-coronavirus-he...

For those who are willing to go through this thought exercise, if we're purely trying to maximize humankind's total well-being, how much wealth would we have to create to counteract one coronavirus victim's loss of life?

Here's a set of 3 questions that I think leads to a possible answer.

- How much would someone have to pay you to be put to sleep for 8 years, during which period you have no sensory input or output?

- Would you rather be put to sleep for 8 years now or at the end of your life?

- Do you have a preference over being put to sleep for the last 8 years of your life vs just dying straight up?

I think most people would be willing to go to sleep for 8 years for $2 million. And, most would prefer dying 8 years sooner over going to sleep now.

In other words, $2m > sleep for 8 years now > dying 8 years earlier == coronavirus victim

The moral dilemma is that we're asking one person to die 8 years sooner to create an outbalanced improvement in quality of life increase for someone else. That is, you're taking away well-being from one person to give to another. I think government officials implement policies that redistribute human well-being all the time, but it raises alarm bells when we start dealing with life and death.

I think you're framing the question - the tradeoff at this point is not how much value will be created but how much value will be destroyed.

The impacts of corona measures will lead to the economic slowdown and general reduction of wealth - for you this might mean that you lose your job, can't afford to buy a new apartment, car, furniture, electronics, clothes, etc. but for people that live close to poverty level that just got out of that place because of globalisation and increased economic growth this will result in less access to basic infrastructure, medications, food, development opportunities.

And that's not even touching the reduction in R&D and economic activity that would improve the lives of people. For example - consider risky tech companies like Tesla being wiped out by market conditions - who is going to do R&D in things like battery tech in an economy where people are pulling out of capital investment ? Even the established companies with cash reserves will scale back R&D. And this will happen across the board - which will in turn make future crisis more difficult to deal with.

Well the dot com bubble comes to mind concerning people not willing to invest in risky tech companies but that didn't stop new tech from coming to the market

When is an X% increase in GDP per capita worth a Y% chance of death? Illegal migrants perform this calculus every day. Their decisions may be instructive.

You don't see people crowding onto fishing boats or hiking treacherous desert to escape Europe ($38k). We can probably afford to fall to that level. It'll be a major lifestyle adjustment, but a doable one.

Looking down the scale to Latin America: Chile, Panama, and Argentina are pretty okay (~$15k). Less so for your typical American middle-class suburbanite, but people have good lives there. Even Brazil is decent (~$10k). But once we start pushing into Mexico, Colombia, Ecuador, etc ($6-7k) the natives start accepting pretty significant risks to get out.

US GDP per capita is about $60k. Although it will be a terrifying shock, we can probably fall to about 10% of that before things are truly desperate. But once we're talking about killing more than 90% of the economy: yes, people might in fact prefer death.

Shouldn't there be a difference between 2m$ I can spend myself 8 years from now and 2m$ that some rich person earns if I die.

Each country has economic and market mitigations. Some are beginning to copy US model of Gov paying bills outright for a period. If everyone can do this with low cost, there's no reason for high risk and damage to economy later. This incident will make us learn fast.

The medical experts do consider economic and market impacts, and there are alignments in governments how to balance everything. However, since this is an unprecedented health crisis with unknown ramifications, that is first priority. Many measures are to create wiggling room to handle what unknown unknowns may come down the road as well.

This shows us systemic vulnerabilities, and societies will be forever changed, probably for the better.

I'm not saying countries are not implementing economic mitigations - I'm saying the only voices in decision making are coming from medical experts - there is no public evaluation or discussion of economic impact as a counterpoint to any action suggested by epidemiologists and doctors. The economy minister here is just putting out fires - he has zero say in the measures taken.

And the politicians in charge are too afraid to debate the experts and frankly lack any leadership at all in this situation - (with a few exceptions in other countries). Blindly listening to experts of one domain because you are afraid is not leadership, they are supposed to do balancing decisions - and from what I see in the media they basically delegated the government responsibilities - if they are discussing this they are certainly not making their discussions or reasoning public.

In my country the different parts of leadership has displayed a unified front in the media and been very clear what they know and that there are unknowns that need to be learned now. If some politicians are "delegating blame" and not taking part, that's indeed a problem. Though it could be a perception problem. I've strong doubts weighted discussions across branches are not happening most sane places. Normal responsibilities during such incidents will be shifted and cease as well.

The issue on the framing of this topic also boils down to who asks it.

I often hear it framed as: "How much is a person's life worth?" or some general reference to stock values.

But when people say "economy" this is what it really means:

https://www.bbc.com/news/world-asia-india-52002734

Cash flow, supply chains, jobs, bankruptcy, debt, poverty, famine and more than likely families breaking up (financial stress is the #1 cause of divorce) plus a spike in suicides.

That's the economic impact. And when the question of virtually guaranteeing that outcome around the world to a significant portion of the global population vs a risk of a negative outcome for for the percentage of people who are susceptible to serious issues from COVID-19...it gets a heck of a lot murkier.

There's not a heartless bad guy in this situation. Both outcomes are terrible and if you purely look at the number of people negatively impacted, the economic fallout of this approach with its cascading effects look significantly worse.

We should not pretend like we understand the "economic fallout", and that operating under the current "rules" is the only mode of existence. Economics and capitalism are social constructs after all. _Nobody_ understands economics well enough to make statements with any certainty. At least epidemiology is better understood.

Not to mention what happens when you take into account the positive effects a recession and drop in production has to: air quality, worker health, general mortality, and climate change?

https://www.nature.com/articles/d41586-019-00210-0

That's fair. It's a lot of moving parts to the system.

This boils down to the reality that governments can take measures to mitigate the economic damage caused by an idled labor force (direct payments to workers), but can do very little to mitigate the economic damage caused by a sick or dying labor force.

And mental health too. How many new Alcoholics will this create? How many suicides?

It's interesting that NOW people are concerned with this impact from the economy, yet when people became alcoholics from getting fired when the economy was good, no one seems to care.

It is about the volumes I guess , millions are filing unemployment claims now , the impact is going to much higher on these issues , lot more people will suffer due to this, so more people have been talking about it .

A healthy and growing economy with low unemployment is a boon to the poor, sick, and alcoholic. The entire purpose of pursuing a healthy economy is that improves the quality of life for the citizens. Continuing to hold this position now is not hypocritical.

There is always a tradeoff.

The virus will kill X and reduce the quality of life for Y people. The economic disruption will kill Z people and reduce the quality of life for Z2.

Quality of life is not a defined term.

There is a difference between trading my life, or trading a new laptop now instead of saving for it. That is what we are looking at here.

So even if my quality of life goes down, food/health/shelter contributes the majority to that, probably 85%. The rest is all worthless junk.

If the economy is failing to the extent that food is in short supply - that is different. There is no indication that will happen.

Ignoring quality of life, there is still a death tradeoff to be considered.

Economic conditions have real and immediate health consequences too. For example, in 2010 US unemployment briefly grew about 6% to a total of 10% in the US and there were 40,000 additional deaths from cancer alone[1]. When you consider heart disease, other indications, drug abuse, and suicide, the numbers are much greater. The often cited number of 40k for each percent unemployment may not be far off if these factors are taken together.

This trend also holds true in the OECD where social programs are more common because there are still budgetary constraints on centralized healthcare.

[1]https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

It's a matter of size. If you have 1% "falling through the cracks", it's individually tragic but not something that will negatively impact the economy that much. If you have 30% falling, you're going to be in for a rough time.

A lot more are falling through the cracks in a good economy than 1%. About what, 10% are poor in the US?

One friend I had in school qualified for free school lunch, so presumably below the poverty line.

His parents had a house, with a yard. There was air conditioning, cable TV, and each child had his own room. I distinctly remember a nearly-server-class PC much better specced than anything my family owned (a dual-processor desktop in the 1990's!)

Poverty stats don't tell the whole story, especially if they're only based on income levels. A wage that would have you living out of your car in SF might allow a squarely lower-middle-class lifestyle in the rural Rust Belt.

You just proved that though - owning a house, with a yard, is not a sign of wealth in most of the US. There are plenty of cheap houses, with yards, to go around. Just not in places most people want to live, leading to less wages and less opportunity because of the lack of jobs.

Most wealthy nations already have a robust social safety net in place. They don't need to rush to cobble together a temporary one in the same was the US does.

This really isn't helpful to the discussion. The US has unemployment benefits, Medicaid, food stamps, and many other programs. And it seems to be pretty premature to declare which country is or isn't going to come out of this with the least amount of damage.

It is a bit of a mystery to me why Congress isn't just providing better funding/financing for all the existing programs. I'm not sure why there should be new types of programs to help individuals. I'm deeply suspicious of efforts to prop up businesses, I'd rather have the focus be on individuals and let businesses figure out the best way forward. For some businesses bankruptcy might be the best solution because the business model has completely changed.

The comment pointed out that the US seems to be tackling the economic impact more aggressively than other nations. That is only partially true to begin with since many other nations are discussing or have already passed large-scale stimulus measures for their national economies.

But the urgency and focus on economic measures in the US does have justification. Here in the US, we need things like free testing (already the case in most nations) and to handle the surge in unemployment (we have a system, is is just less robust than most wealthy nations, hence the very urgent need to dramatically expand it).

I made no mention of "which country is or isn't going to come out of this with the least amount of damage", only reiterated the well-known fact that the US has one of the meekest welfare states of any wealthy nation. That had not yet been mentioned in the thread and seemed extremely relevant.

I saw this idea floated around on Reddit a few days ago. Basically the crux is that unemployment has a death toll, too.

So if you close all non-essential businesses, unemployment rises, which increases the likelihood of people losing health insurance, losing homes, not paying electrical bills, communication (internet / phone) bills, etc. If some people lose all those things and don't have access to them again for 2+ months, and have no other safety net, they might die. Doubly so considering the hospitals may be at capacity with COVID-19 cases.

So, what would be better - keep people at home and unemployed, where people die by lack of resources, or keep people going out where people die by spreading COVID-19?

The third options is to keep people at their residences but either pay them or reduce their bills / mortgages etc to 0 while COVID-19 blows over. But that could take 2-18 months. It was hard enough getting $1200 once for every American household - I doubt it will continue for another 18 months until a vaccine is developed.

You've rightly identified the question as a false dichotomy. People in the US don't _have_ to die for lack of resources.

The state helping the people to survive this crisis or not is a political choice.

I'm not really worried about lack of raw resources and immediate needs. We'll figure that out via a mix of savings, private charity, and local/state/federal assistance. I'm assuming that we'll mitigate the virus via treatments, vaccines, or the brutal reality of acquired immunity.

The more difficult political problem is how the financial pain is going to be distributed and how we reboot the economy. How assistance is distributed, taxes are adjusted, or fiscal measures are taken is going to be very complicated with opportunities to create winners and losers based on the policies. So far I'm not particularly impressed by Congress in this area.

> I doubt it will continue for another 18 months until a vaccine is developed.

If any of the 40+ trials going on for drugs is successful and makes COVID-19 clinically manageable, it would improve the situation earlier than just waiting out a vaccine (which, like the drugs, may not work at all).

None of my expenses have changed. And as far as I know, it would be a problem if I lost my income as I would still need to pay rent/mortgage, taxes, groceries, utilities, health insurance.

I think what you are saying is that discretionary expenses have been greatly reduced. That is true, but I think you then make a very big leap to assuming the savings can easily offset the fixed expenses that you mention (insurance, rent/mortgage, utilities).

Boy that's news to me.