COVID-19 in Boston

Arlington

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We are going to need a way to keep doing any work that can be done. (I wonder if I googled hard enough I could show germ transmission rates by job type).
 

stellarfun

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Governor orders Stay-At-Home, starting tomorrow. Basically lasting two weeks. Nearly all construction projects will shut down (didn't see on a quick glance any exemptions for certain types of projects, e.g., residential).
 

Brad Plaid

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The country (the world) is rapidly going scorched-earth policy in what could be a well-intentioned but very misguided containment effort. These efforts seem to be guided in large part by the doomsday, near-end-of-the-world speculations of Imperial College. How are they qualified to be apocalypse "experts"? A degree of skepticism and questioning of their findings is necessary here—they could be Chicken Little sky-is-falling hysterics. We cannot have a scenario where great grandma is saved but the economy dies. We can have a scenario where both great grandma and the economy are saved—the coolest of heads must prevail—the global economy cannot be sacrificed.
 

George_Apley

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Our health care systems don't have to capacity to handle the effects of *not* slowing down the economy. No one is trying to contain the virus anymore. This is about "flattening the curve" so that the infection rate is slow but steady, rather than sharp spikes.
 

KentXie

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The country (the world) is rapidly going scorched-earth policy in what could be a well-intentioned but very misguided containment effort. These efforts seem to be guided in large part by the doomsday, near-end-of-the-world speculations of Imperial College. How are they qualified to be apocalypse "experts"? A degree of skepticism and questioning of their findings is necessary here—they could be Chicken Little sky-is-falling hysterics. We cannot have a scenario where great grandma is saved but the economy dies. We can have a scenario where both great grandma and the economy are saved—the coolest of heads must prevail—the global economy cannot be sacrificed.
Even if there were no stay-at-home order, the number of employees refusing to come into work, either because they don't want to expose themselves to potentially getting sick or because they themselves have contracted the disease and needs to be quarantine, couple that would a loss in demand in several industries such as airline and tourism would have tanked the global economy regardless. The economy is going down one way or the other, with one resulting in fewer deaths.
 
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chmeeee

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The country (the world) is rapidly going scorched-earth policy in what could be a well-intentioned but very misguided containment effort. These efforts seem to be guided in large part by the doomsday, near-end-of-the-world speculations of Imperial College. How are they qualified to be apocalypse "experts"? A degree of skepticism and questioning of their findings is necessary here—they could be Chicken Little sky-is-falling hysterics. We cannot have a scenario where great grandma is saved but the economy dies. We can have a scenario where both great grandma and the economy are saved—the coolest of heads must prevail—the global economy cannot be sacrificed.
Read the description of what's happening to even middle aged people with this thing and let me know if you still think we should just pretend like it's business as usual.

 

kmp1284

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Read the description of what's happening to even middle aged people with this thing and let me know if you still think we should just pretend like it's business as usual.

The people still spewing what Brad is are either willfully ignorant or sociopathic and in either case no amount of suffering is enough to change their mind. Some thrive on it even.
 

Cosakita18

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Might want to figure out some new hobbies. I suspect everything that can be mothballed or cancelled will be.
I'm going to echo something I said in the Portland subforum, but I would be very surprised if any projects in the development pipeline continue in their current form (In Boston, Providence, Portland, or really anywhere) I suspect that once current projects wrap up, there will be a 6 month - 1 year period where there is almost no major construction going on. Even in the best-case economic scenario, it's going to take months or even years to get the wheels of the economy spinning again.
 

DZH22

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I'm going to echo something I said in the Portland subforum, but I would be very surprised if any projects in the development pipeline continue in their current form (In Boston, Providence, Portland, or really anywhere) I suspect that once current projects wrap up, there will be a 6 month - 1 year period where there is almost no major construction going on. Even in the best-case economic scenario, it's going to take months or even years to get the wheels of the economy spinning again.
Honestly, if Winthrop Square and State Street are still built, I can live with delays in future projects for... a while. State Street is extremely important because we lost all the similar rounded stuff already (Copley Tower and 1 Bromfield) so this is really the last showstopper we have left.
 

jklo

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It's gonna be anarchy by Summer if the status quo remains.
 

George_Apley

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Debatable. The two are deeply intertwined.
What I fail to understand is how not shutting things down would help the economy. There's an assumption that the economy would just keep humming right along absent the government intervention we're seeing. I don't buy it. How well would the economy operate if all the hospitals were overflowing and people were panicking even more than they are now? A lack of government intervention would lead to anarchy even more quickly.

What should we be doing instead? We can't use hindsight. What should we do now if not try to decrease and slow transmissions of this virus using social distancing?
 

fattony

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What I fail to understand is how not shutting things down would help the economy. There's an assumption that the economy would just keep humming right along absent the government intervention we're seeing. I don't buy it. How well would the economy operate if all the hospitals were overflowing and people were panicking even more than they are now? A lack of government intervention would lead to anarchy even more quickly.

What should we be doing instead? We can't use hindsight. What should we do now if not try to decrease and slow transmissions of this virus using social distancing?
Knowing the optimal thing to do is hard, probably impossible. Even the first step of that is deciding what to optimize for and that is not clear. There are massive negative consequences to human lives if we cripple the economy too much. There won’t be resources to care for normal illnesses and accidents in the near future if the economy cannot get restarted. There are surprising positives too - I read an estimate that as many as 40,000 lives have been saved in China due to reduced air pollution during the past 3 months. Everything is interconnected in a vast web of feedback loops.

It is clear that social distancing is prudent ... for now. The question of how long to do it is very hard to answer. We are staring down the barrel of sustained 20-30% unemployment on the other side of this. Other countries will far worse than the US on that front. It’s hard to put your finger on the deaths that would be avoided if that massive unemployment doesn’t happen, but you can’t deny it’s a big number.

There is already a recession. That is unavoidable. How deep it is will determine the live and deaths of millions of people for decades to come. I’m glad it’s not my job to decide what to do. It’s an impossible choice to pick who lives and dies, even in the abstract.
 

Brad Plaid

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I knew there would be some knee-jerk flack for daring to question the worst case scenarios and whether current strategy is the right thing to do or should there be re-evaluations and re-adjustments but some of these comments are just a bit much. There has to be a willingness to consider alternative strategies if only to confirm that what is being done is the right thing to do, inflexible dogma is a dangerous thing.

How does a broken economy help keep the supply chains open and running for the manufacture and delivery of such critical things as respirators and masks? How does a broken economy help keep hospitals, doctors, nurses, all medical providers doing their heroic work? How does a broken economy help keep the search for a “cure” going at full breakneck speed? How does a broken economy help keep police, fire and first responders doing their essential jobs? How does a broken economy help keep the support services necessary for all of the above going?

And for the rest of us: How does a broken economy help keep your kids fed, educated and safe? How does a broken economy help keep the heat and lights on, the water running, the phone working? How does a broken economy help you go where you need to go whether by car or transit? How does a broken economy help keep public order or crime from running rampant? How does a broken economy help keep intact a sense of shared community and looking out for your neighbors? How does a broken economy help keep personal financial fears and anxieties that take physical as well as mental tolls under control?

A functioning economy is as vital a part of beating this demonic virus as respirators and masks. The post-covid landscape can either resemble an earthquake zone or not. Stay positive, stay optimistic.
 

kmp1284

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I knew there would be some knee-jerk flack for daring to question the worst case scenarios
And who are you to intelligently question anything here? What credentials and experience do you have in medicine and public health?
 

George_Apley

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I knew there would be some knee-jerk flack for daring to question the worst case scenarios and whether current strategy is the right thing to do or should there be re-evaluations and re-adjustments but some of these comments are just a bit much. There has to be a willingness to consider alternative strategies if only to confirm that what is being done is the right thing to do, inflexible dogma is a dangerous thing.

How does a broken economy help keep the supply chains open and running for the manufacture and delivery of such critical things as respirators and masks? How does a broken economy help keep hospitals, doctors, nurses, all medical providers doing their heroic work? How does a broken economy help keep the search for a “cure” going at full breakneck speed? How does a broken economy help keep police, fire and first responders doing their essential jobs? How does a broken economy help keep the support services necessary for all of the above going?

And for the rest of us: How does a broken economy help keep your kids fed, educated and safe? How does a broken economy help keep the heat and lights on, the water running, the phone working? How does a broken economy help you go where you need to go whether by car or transit? How does a broken economy help keep public order or crime from running rampant? How does a broken economy help keep intact a sense of shared community and looking out for your neighbors? How does a broken economy help keep personal financial fears and anxieties that take physical as well as mental tolls under control?

A functioning economy is as vital a part of beating this demonic virus as respirators and masks. The post-covid landscape can either resemble an earthquake zone or not. Stay positive, stay optimistic.
The answer is good public policy. In hindsight, we should have been much more prepared for this occurrence. We weren’t. We willfully weren’t. Going forward, public policy can mitigate some of the negative effects of a closed down economy for the mid-term. But we have a hard time with that too. Electing a narcissistic mobster is making that much more difficult.

You're doing a fine job and playing the contrarian, but what do you think we should be doing instead of what we’re doing? You’re just questioning.
 

DZH22

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I have been studying the numbers, and when all is said and done I think anything under 1,000,000 worldwide deaths would have to be considered a win. We really need a bleeping miracle, but it's a planetary effort so at least there's a chance. Otherwise we could be talking about a death toll that rivals all the dead from WW2. Things are going to get crazy over the next couple of weeks/months.
 

George_Apley

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This Twitter thread from the Johns Hopkins’ director of the center for health security captures my thinking and why I really struggle with all the contrarians.

In last 24 hrs there've been prominent US voices calling for a stop to social distancing, citing rationale that they're worse than impact of COVID itself. It’s worth looking very closely at that claim, where we are in US COVID epidemic and what happens if we stop. 1/x

COVID has been spreading w/ exponential growth in US for some time, and we're just beginning to get an understanding of how extensively. There
are nearly 40,000 cases recognized in the US as of today, w/ ~100 deaths
today. A few weeks ago, we had recognized 70 cases total. 2/x

Some hospitals have said publicly that within a week they will not have ventilators to treat everyone with COVID anymore. 3/x

There continue to be big diagnostic limitations. Shortages in reagents, swabs. Don’t have rapid diagnostics in many hospitals yet, so it can be days before doctors and nurses can find out if a pt in front of them has COVID. 4/x

We don’t have capacity to diagnose many of the COVID cases that are not sick enough to be in the hospital, so those numbers aren’t counted in our national totals. 5/x

There continues to be terrible shortages in the masks that health care workers need to keep from getting sick with this disease. 6/x

How do we gain time to let hosps get more supplies & prepare for high number of pts? How do we lower the speed of spread of COVID in US? How do we lower odds that ICUs will run out of vents, hospitals run out of space? The answer for now is large scale social distancing.7/x

In Asia, we've seen these interventions work to lower
pace of the epidemic, lower numbers of critically ill, lower
the number of people who get COVID. In
Asia where big social distancing measures have been in place for two months,
they have had very strong impact. 8/x

In Asia they've slowed the disease by slowing social interaction. Left to its own, this disease spreads from 1 person to about 2.5 people, and then they do the same, and so on. For this disease to stop, we need to make it so that the avg person spreads it to <1 other person. 9/x

These big social distancing measures take time to work. The impact of big interventions in Wuhan China took about 3 wks to start to reverse things. And then everyday after the situation got better. In the US, we're about 7 to 10 days into this, depending on the state.10/x

To drop all these measures now would be to accept that COVID pts will get sick in extraordinary numbers all over the country, far beyond
what the US health care system could bear. 11/x

Many models report that health care systems will be completely overwhelmed/collapse by the peak of cases if major social distancing is not put in place. 12/x

If a health care system in a given community stops working, can no longer provide care to the ill, the case fatality rate for COVID will be far higher than 1% - we would not be able to care for some or all of the expected 5% of recognized cases that get critically ill. 13/x

Beyond that, if hospitals were completely overwhelmed, they may struggle
to provide even oxygen for some or many of the 15% of recognized cases expected to be “severely ill”. let alone provide care for other life threatening conditions. 14/x

Anyone advising the end of social distancing now, needs to fully understand what the country will look like if we do that. COVID would spread widely, rapidly, terribly, could kill potentially millions in the yr ahead with huge social and economic impact across the country. 15/x

Before considering big changes to social distancing measures
now, we should as quickly as possible get to strongest possible position for COVID response – we're no where near that now. We'll need rapid Dxs in place almost every location where a pt can be seen for care.16/x

We'll need extraordinary quantity, reserve+production lines
of masks, PPE so that shortages at hosps and clinical sites around country
are no longer possible. We'lll need to have more vents on the way. We'll need capacity to provide med care to many more that we can now.17/x

We'll need to reduce the # of cases to such a low
level that we could again do contact tracing & isolation of cases around
the country (as they can in many countries in Asia now). 18/x

We will need system of screening at airports
so that no person comes into the country with the disease without being
diagnosed and isolated. 19/x

We'll need a serology test that can be used to identify those that have been infected and recovered already, and to know how prevalent disease is in the US. We would hopefully have therapies developed and in a quantity that we can treat at least the sickest pt w COVID. 20/x

Once we have those things in place, it would be a far less risky time to take stock of social distancing measures in place and consider what might gradually be reduced with trial and error. We would have learned more about the experience
in Asia as they try to do that.21/x

For now we need to keep production running, doctors offices working, groceries, pharmacies, banks open. It is ok to have science informed dialogue about which businesses need to be closed vs what can stay open in some way if social distancing can be put in place in them.22/x

But we need to press ahead for now w closed schools, mass
telecommuting, no gatherings, strong advisory to stay home unless you need to
go out – all are needed to slow this epidemic. 23/x

We also need to put every conceivable econ program in place to help those being hurt by these social distancing measures. And move ahead rapidly to get our country far better prepared to cope w COVID before people recommend we abandon our efforts to slow this virus. 24/x
 
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