HACKER Q&A
📣 DougN7

Isolation (from coronavirus) is only a temporary band-aid that will fail


One infected person infects 2 to 3 other people on average. This is exponential spread. This will remain true until enough people have immunity that the chance of infecting someone new drops below 1. This is the so called "herd immunity". This requires 60-70% of a population to have immunity.

Immunity comes from a person having been exposed to the virus and getting better, or a vaccine. To get to the 60-70% point in the US, roughly 220 million people need to be exposed and heal, or get vaccinated.

Getting 220 million people exposed, at a rate of 1 million per month (which will still overwhelm the health care system) would take almost 20 years. Flattening the curve simply takes too long with such a large population. Finding, creating, distributing and vaccinating 220 million people would take a number of years? (guessing on that).

No government can afford to pump $1 trillion into the economy every quarter to prop it up, and do this for a number of years. They will have to start printing money to do that, which leads directly to hyperinflation, which destroys countries and leads to starvation and death.

Isolation delays the inevitable but doesn't stop it. Testing and tracing contacts to isolate the infected only works if it is perfect. If we miss 1 person out of 330 million in the US, that 1 person will start the entire cycle again. China is not out of the woods - if they missed 1 person the cycle will begin again.

Where is the hole in the above rationale?

(I wish the above wasn't true, but my wishes don't count for anything)


  👤 sova Accepted Answer ✓
IANAE, Some of the simulations featured on HN reaffirm the fact that the sweep through the population must happen, but the relative concentration of virus per individual can be minimized. This will help minimize deaths, because if any one immune system is overloaded it cannot cope. It is like a tsunami that everyone must ride, but the relative strength of that tsunami can be curbed by minimizing cross-contact that inadvertently increases virus concentrations per person.

👤 sharemywin
Hospitals. If the hospitals get over run like in Italy, 1% goes to 2% or more. Remember roughly 10% of the population will need hospitalization and ~40% are 20-50. We're in very short supply of all kinds of vital hospital items.

👤 solarkraft
> Ask HN: Isolation (from coronavirus) is only a temporary band-aid that will fail

This is not a question.

> (I wish the above wasn't true, but my wishes don't count for anything)

I grant your wish.

> Where is the hole in the above rationale?

The number of people an infected person infects is hopefully driven (far) below 1 through lock down.

If no vaccine will be available soon enough, the curve can be steepened again as far as people can be treated to achieve immunity more quickly.

It's a good time to be a maker of ventilators.


👤 gus_massa
edited> Isolation is only a temporary band-aid

Yep :(

> Getting 220 million people exposed, at a rate of 1 million per month [...] would take almost 20 years.

There are too many uncertain details, so it could be 10 or 30 or 5 o ... Also, there is hopefully some work to solve the bottlenecks (like ventilators, or soon the overworked nurses and doctors), so the number of ill people that don't overwhelm the health system can grow and reduce the duration of the problem.

> Finding, creating, distributing and vaccinating 220 million people would take a number of years?

Probably two years if someone promise to pay the bill. There are some prototypes and some optimistic estimations say 18 month. Don't expect to see the vaccine in less than a year, but hopefully it will be finished in two years.

> If we miss 1 person out of 330 million in the US, that 1 person will start the entire cycle again.

The isolation can work at the state or county level, that is easier to control and you can move some extra resources to the area. If the number of ill people is small enough you can isolate the person, whoever meet her/him, and whoever meet the persons that meet her/him. This is used with other illness, but it's easier if you have a vaccine to create a few concentrically rings of immunized people.


👤 chub500
My amateur take:

1. Drug therapy may enable the "severe" hispitalization required cases to drop into stay at home cases.

2. It is not yet established at all that huge testing capacity + travel restrictions cant curb spread. See the Gates AMA.

However, it seems certain policies and travel restrictions will remain until an effective vaccine is available.


👤 c89X
eh, a vaccine becoming available in the next year or two?