Coronavirus 3: The Resurgence

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I get the sense that trying to run a country with loose enough restrictions such that R>1 in general, while controlling entry to prevent spread is going to be a fundamentally unstable situation for the foreseeable future.

Like having a vast swath of terrain that's highly flammable and only trying to indefinitely suppress it ever catching on fire, rather than managing it to reduce flammability.

I'm not sure I understand what you're saying here
 
Yes, which is going to be a fundamentally unstable situation for years.

Not really. End of next year if there's not vaccine then they can stock up on ppe, ventilators etc then throw open the borders.

Or you just do giant bubbles with similar nations. Just means tourism is goneburger.

Australia and NZ not in that much debt. They can deficit spend for 5-10 years before they get to the levels USA started with.

That will put us on roughly WW1/2 levels of debt. Economic benefits to being Covid free as well.
 
I'm slightly concerned that the numbers show a slight uptick in cases for Austria and Switzerland. Both countries seem to have it under control, so another wave would be very concerning.
And while I have not read any news about South America, I guess it's going pretty awful down there. Chile, which has a population size similar to the Netherlands, has 6 times its cases, and a worse healthcare system. I do not want to imagine...

Here Jan-May compared to last year for the 5 biggest airports in the Netherlands.
As you can see passenger flights (light blue) are down in April-May with 90% and passengers (dark blue) with almost 100%.
Freight is green.
National lockdown started in March.


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I was like "which big 5 airports o_O?" and had to look it up on Wikipedia :lol:.
And nice, Flamingo International Airport (Bonaire) :lol:.

California has been added to the list of states where residents from it who (whom?) travel to New York must undergo a 14 day quarantine. So there goes any chance I'll be able to go to my brother's wedding and get to see the big apple this year. :(

...if NY doesn't have a second wave.
So... better get a life stream than your brother needing to cancel it.


EDIT: Just going through the Science newsletter right now, and:
https://science.sciencemag.org/content/369/6499/77
Vaccine candidate tested in monkeys
Global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to an urgent race to develop a vaccine. Gao et al. report preclinical results of an early vaccine candidate called PiCoVacc, which protected rhesus macaque monkeys against SARS-CoV-2 infection when analyzed in short-term studies. The researchers obtained multiple SARS-CoV-2 strains from 11 hospitalized patients across the world and then chemically inactivated the harmful properties of the virus. Animals were immunized with one of two vaccine doses and then inoculated with SARS-CoV-2. Those that received the lowest dose showed signs of controlling the infection, and those receiving the highest dose appeared more protected and did not have detectable viral loads in the pharynx or lungs at 7 days after infection. The next steps will be testing for safety and efficacy in humans.
 
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And nice, Flamingo International Airport (Bonaire) :lol:.

Our rather confusing construction of "the Netherlands" and "Kingdom of the Netherlands" and former colonies who prefer to be autonomous without leaving our Crown.
We, the Netherlands, expected to pay for hurricane and Covid damage, which we ofc do because of so many people here with family members there.

But those 5 biggest airports were all truly Dutch airports: Amsterdam, the Hague-Rotterdam, Eindhoven, Groningen, Maastricht-Aachen.
And yes... a Dutch airport referring to as well the nearby German City Aachen.
Charlemagne would agree.

I'm slightly concerned that the numbers show a slight uptick in cases for Austria and Switzerland. Both countries seem to have it under control, so another wave would be very concerning.
And while I have not read any news about South America, I guess it's going pretty awful down there. Chile, which has a population size similar to the Netherlands, has 6 times its cases, and a worse healthcare system. I do not want to imagine...

Balkan is having flare ups everywhere as well.
Serbia accused of reporting far less cases than reality until the elections were done on June 21.
Besides that Serbian tennis tournament ignoring Covid completely causing cases between those stars, here below the Serbian football derby ignoring Covid causing a superspreader event.
In the Netherlands spectators are allowed since Jul 1. They have to keep 1.5 meter distance and have to shout and sing at whisper level.
I have no good feeling about that, but perhaps it is only to get the mass experiments done and prove to the fans that they are not able to discipline themselves enough and then forbid it for some or all clubs. And perhaps some clubs are able to handle it ?

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I'm not sure I understand what you're saying here

Making an observation. Trying to disabuse people of the idea that it's possible to reach a stable equilibrium without covid in the short to medium term. Doesn't mean instability in response isn't necessarily a preferred policy choice, but people in general do not seem to have a good intuitive grasp of the effects of public health policy vis-à-vis the spread of disease, and what types of equilibrium are possible on different time scales.

Not really. End of next year if there's not vaccine then they can stock up on ppe, ventilators etc then throw open the borders.

If there's not a vaccine at the end of next year, then nothing has changed from right now. You're just describing doing what every other country is already doing, which is obviously not the unstable scenario I'm talking about.
 
I get the sense that trying to run a country with loose enough restrictions such that R>1 in general, while controlling entry to prevent spread is going to be a fundamentally unstable situation for the foreseeable future.

Like having a vast swath of terrain that's highly flammable and only trying to indefinitely suppress it ever catching on fire, rather than managing it to reduce flammability.

It raises problems, but there are also obvious problems with trying to "manage" the virus instead of extinguishing it: is a more fundamentally unstable situation, judging from the creeping up of cases we're seeing all over the world after the lockdowns where it wasn't extinguished locally.

Look at the evidence: Europe is still in a crappy situation:
a) epidemiologically: outbreaks flaring up everywhere
b) economically: many businesses that depend on crowding shut down or operating well below capacity
c) socially: people increasingly tired of restriction, and many facing unemployment

Whereas countries that extinguished the virus can:
a) allow efforts of containment to concentrate on a few ports of entry
b) allow the vast majority of economic activities to go back to normal, recover the stock levels and capability to deal with new disasters if necessary
c) allow people to rest from this stress, personal, financial, etc.

The cost of this is solely giving up on international tourism, the only activity that cannot be adapted to quarantines. It's an obvious choice to make.

Look at the reasoning above: the right policy to follow is extinguish the virus. If and when it comes back there remains the ability to extinguishing it again. With widespread testing (and we now know we can monitor for it even though sewers) it can be caught early and extinguished without any any lengthy new lockdown.
And look at the evidence too: those countries that went "we'll just manage the virus at a low level" and opened early are now facing never-ending restrictions, half-empty businesses (it isn't the government imposing lockdowns, it's enough people who changed behaviours), and not enough tourism anyway. As a policy it was totally stupid.
 
It raises problems, but there are also obvious problems with trying to "manage" the virus instead of extinguishing it: is a more fundamentally unstable situation, judging from the creeping up of cases we're seeing all over the world after the lockdowns where it wasn't extinguished locally.

Look at the evidence: Europe is still in a crappy situation:
a) epidemiologically: outbreaks flaring up everywhere
b) economically: many businesses that depend on crowding shut down or operating well below capacity
c) socially: people increasingly tired of restriction, and many facing unemployment

Whereas countries that extinguished the virus can:
a) allow efforts of containment to concentrate on a few ports of entry
b) allow the vast majority of economic activities to go back to normal, recover the stock levels and capability to deal with new disasters if necessary
c) allow people to rest from this stress, personal, financial, etc.

The cost of this is solely giving up on international tourism, the only activity that cannot be adapted to quarantines. It's an obvious choice to make.

Look at the reasoning above: the right policy to follow is extinguish the virus. If and when it comes back there remains the ability to extinguishing it again. With widespread testing (and we now know we can monitor for it even though sewers) it can be caught early and extinguished without any any lengthy new lockdown.
And look at the evidence too: those countries that went "we'll just manage the virus at a low level" and opened early are now facing never-ending restrictions, half-empty businesses (it isn't the government imposing lockdowns, it's enough people who changed behaviours), and not enough tourism anyway. As a policy it was totally stupid.

"Managing" with R<1 is a fundamentally stable situation, regardless of whether the virus is already extinguished locally or the situation at the borders. The stability of the situation isn't contingent on whether it's being managed or not, or the current number of cases, it's contingent on R<1 or R>1.
 
With widespread testing (and we now know we can monitor for it even though sewers)

We have in NL since begin April the steady monitoring of 29 sewer points and will by Sep 1 have 300 steady sewer monitoring points. That's about 1 per 55,000 people as one of the several early warning systems of our dashboard.

The summer holiday period will be an experiment at mass scale of many relaxations of the lockdown.

We are in NL left with only the 1.5 meter, the sanitising discipline, the home office priority, the 35 convenants per economy sector for precise procedures, and no mass festivals.
The flare ups and follow up contact tracing on the flare ups should provide data for the R modelling. Analysis of transmission rates between personas (stereotyping people regarding social contacts and transmission into a big matrix) very important.
Active contact tracing has always been kept up to some degree in the three northern provinces from March onward (lowest infection rates and another test tech than in other provinces) and the other, at first overwhelmed provinces are up and running since June 1. On average 8 work hours needed per confirmed case that can be used for contact tracing. Hit rate on requests from citizens approx 1%, hit rate on contacts of a found confirmed case approx 14%.
Will for sure take some months before the staff AND our population is fully in the groove to max the potential sweeping effect of contact tracing.

All in all I see a preparation to be "in control" in autumn for whatever strategy is then chosen based on more data and knowledge than we have now.

I do think myself that it pays economically for the EU countries to forbid wintersport for this winter in foreign countries.
Domestic freedom will be more important for the domestic economy and social health. Quarantine tresholds to slow moving fellow EU countries unavoidable. National prides will be hurt.

Where we are in June next year with that desperate need for summer holidays is imo impossible to predict.
We sail on sight.
 
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"Managing" with R<1 is a fundamentally stable situation, regardless of whether the virus is already extinguished locally or the situation at the borders. The stability of the situation isn't contingent on whether it's being managed or not, or the current number of cases, it's contingent on R<1 or R>1.

You are thinking small. This is not a technical issue of finding and applying a set of procedures to control the virus. It's an issue of what can be maintained for the long term.
That situation is fundamentally unstable because the requirements for managing the virus effectively are socially destabilizing. In many countries (just look south of the border from yours) apparently impossible already.
An optimist will say it'll get better with time, people will adjust. I see it as a pressure cooker, it'll explode.

Whereas the requirements for controlling at the borders are way less onerous on society.
This tradeoff may not be so in continent-sized countries like the US or Brasil, or Canada or Australia. But in Europe the borders are already (or still) there, and so is the regional (national) organization) to manage it.

Even so Australia, which enforced restrictions on travel between states, is doing well. And the US is being forced to resort to that also. Is these are disruptive then the sooner the virus is eliminated the less cumulative disruption (pressure) will accumulate.
 
As long as there is an more or less even spread of new cases, closing borders accomplishes exactly nothing.
 
And some countries have also managed better quality info and have also "managed" a better relation in terms of understanding and trust with neigboring countries at regional and national level.
Some countries and/or regions will have that win-win with each other. Some not.
 
As long as there is an more or less even spread of new cases, closing borders accomplishes exactly nothing.

In my opinion there are two types of border crossing. Local and non local.

Let me explain.

A: If someone living five miles from a border with an adjacent state gets in the car and drives 10 miles and returns, that is a local crossing.
B: But if someone has to get in a crowded aeroplane, bus, boat or train for several hours, that is a non local crossing.

For local crossings, such as Type A, the individual is no more likely to catch or transmit the
virus crossing the border than if they travel the same distance within their own state.

But for non local crossings such as Type B, the process of travel itself risks spreading the virus.
 
In my opinion there are two types of border crossing. Local and non local.

Let me explain.

A: If someone living five miles from a border with an adjacent state gets in the car and drives 10 miles and returns, that is a local crossing.
B: But if someone has to get in a crowded aeroplane, bus, boat or train for several hours, that is a non local crossing.

For local crossings, such as Type A, the individual is no more likely to catch or transmit the
virus crossing the border than if they travel the same distance within their own state.

But for non local crossings such as Type B, the process of travel itself risks spreading the virus.

yes
and that means that after this summer holiday season and some unpredictable effects... governments will have to get serious again.

For me the basic criterium is the reliability of forecasting by governments of their non-isolated free running amount of infected cases per capita (which includes the effectiveness of containing flare ups).
This is much more difficult than just adding up the tested confirmed cases that we can see in the JHU stats.
Countries not having a similar low level cases per capita and/or not able to forecast reliable are not fit or not reliable as partners to have unrestricted travel with.
As I said: national prides are gonna be hurt in the EU.
And forbidding all EU members to cross-border just to save face of a few countries who do not hook on is for me not acceptable.
There is a lot of hard work to be done by the health authorities to get the machinery up and running before autumn.
And that can include distancing from former points of view by experts and leading politicians used in the initial peak flattening.
Good Luck to us all !
 
As long as there is an more or less even spread of new cases, closing borders accomplishes exactly nothing.

The issue is whether a decision was made that closing borders - actually, imposing quarantines on those crossing borders - is acceptable or not.

Any country that deems that unacceptable automatically makes a policy decision of not attempting the strategy of extinguishing the virus. Because if they did extinguish the virus soon someone would bring it in again. Therefore they consider it pointless to even attempt to extinguish the virus and necessary must fall back on the "manage the virus" policy.

What I am trying to point out is that this logic is unsound. It's wrong and damaging. The policy of extinguishing the virus and afterwards carefully dropping quarantines with other countries that embrace the same policy is a better one. Controls on borders meant constant vigilance just in some places are way less damaging that eternal vigilance always and everywhere. It's foolhardy to depend on a vaccine being done anytime soon.

People - most governments! - desperately holding on to an illusion of getting back to normal are preventing us all from going back to almost normal, rejecting a priori the only viable strategy currently that allows for that.

That's exactly my point.

I don't think you're yet explained your point clearly. What do you defend as a policy?

I'm essentially pessimistic on the possibility of avoiding social breakup by carrying on as we are: case are likely to rise as we go into the autumn, new lockdowns will happen, patience will be stretched thin in several ways.
Obviously it's also impossible to let the virus run rampart: even where governments didn't care, people do!
The only chance of dealing to this and finding a stable situation is to get rid of the virus. If it can't be done worldwide then it must be done regionally. That has been proven to be possible. Then keeping it out still requires some vigilance, some changes, but far less than "managing" the virus.

You don't simply manage a damaging fire: you extinguish it where possible. And you don't ignore it and say "there's fuel around, no point in putting it out because it'd just burn some other day". Might as well kill yourself claiming that life is not stable, only death is! That's a pointless defeatist and absurd attitude. But that's what many governments are doing now... it's people who first erred, and now will be afraid to admit they made a mistake.

Nothing like a crisis to show how badly government most of the world is. It's failing under a combination of unchallenged wishful thinking (conformity among the elites...), technical incompetence, and bad social organization (no room for leadership because nothing new can be attempted). :mad:
If it hadn't hit china first and let them set the example of locking down and quarantining, I wonder what the "leaders" who govern countries would have done. Do their best impersonation of the proverbial ostriches is my guess.
 
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With a quick elimination impossible and developing a vaccin taking too much time: the data required to handle this virus can only be acquired by having a low infection rate during a long enough time to do enough tests.

Do I like that ?
No

Current level in many countries with a decent managing of the disease has a Covid death rate of around 1% of the normal mortality rate (0.25 deaths per day per million vs 25 deaths per day per million)

Is that acceptable ?
I am afraid we cannot do much better.


Consider that we do talk about public health and that is another animal than individual health care.
And we do need to find out how to handle the next pandemy.
Hard evidence based.
Hard enough to survive politics from future politicians who are a master in creating political realities at the expense of handling real realities.
Otherwise we are with the next pandemy again too late with closing down our airports, are again under-equipped, etc.

We are in a sense lucky with this virus... it could have been a much more nasty one.
 
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