There is an extremely sobering report in today’s New York Times that cites an even more sobering report by London infectious disease experts, predicting that while shutting schools and businesses and other extreme “social distancing” measures can be very effective at reducing the number of coronavirus cases in a matter of weeks (that’s good!), a more-or-less-total lockdown would need to be in place until a vaccine is developed or else cases would immediately flare up again to catastrophic levels (that’s eeeagh!).
The Times article and the London report are both worth reading, but here’s the key chart from the latter: 
The green and orange lines are what we want to look at here: They represent the consequences of imposing five months of school closings and “social distancing” measures like we’re now heading toward (the San Francisco Bay Area is now on full Italy-style lockdown as of this morning, and I expect — I hope — that other regions will soon follow suit). As you can see, even without closing schools the curve flattens dramatically, though a closeup view shows that closing schools (green line) can make a huge difference in keeping hospitals from being overwhelmed:
The problem comes when we get to the right side of the graph, after the theoretical five-month “suppression” measures (the blue shaded area) are lifted. As you can see, about six weeks later, infections surge again, and we’re soon right back where we are now, with hospitals overwhelmed and millions of deaths. At which point the only possible solution is to go back on lockdown, resulting in a one-month-outside-two-months-inside cycle that would have to continue until a vaccine or other prophylactic treatments are developed:
Aside from being a terrifying vision of our potential near future — early vaccine trials have already begun, but even then a best-case scenario is no vaccine will be ready until well into 2021 — clearly this would mean the sports world isn’t going to return to normal anytime soon, unless all sports seasons can be reduced to four-week tournaments.
(Interestingly, the London report says that “Stopping mass gatherings is predicted to have relatively little impact because the contact-time at such events is relatively small compared to the time spent at home, in schools or workplaces and in other community locations such as bars and restaurants.” That would imply that what’s mostly important is keeping people from prolonged contact in enclosed spaces like schools and offices, not going to outdoor concerts or sporting events — something that other anecdotal evidence is already hinting at. Still, it’s hard to envision a world where nobody goes to work or school but everybody still goes to baseball games.)
So are we really doomed to a year or two of, at best, sports becoming a sporadic series of empty-stadium events to keep us entertained once we’ve exhausted everything available on Netflix? Maybe … but then there is the contradictory series of articles coming out of China, which, we are told, is rapidly returning to normalcy after seeing new infections peak, then fall:
For a city whose soul is “hotpot flavoured”, as some playfully describe it, the reopening of Chengdu’s hotpot restaurants gives residents an almost unparalleled reassurance that the worst of the outbreak has indeed passed.
“We are only allowed to accept 50 percent of our restaurant’s maximum capacity for dine-in guests, and that’s the rule for all restaurants in Sichuan (the surrounding province),” Xiao Ma, a waiter at Shudaxia, a famous hotpot restaurant in Chengdu, said. “But in the last few days, we have been hitting that line almost non-stop.”
If true, that could be a sign that it’s easier than the London experts are assuming to get infection rates down to a point where they can be kept low by universal testing and contact tracing, plus immediate quarantining of anyone found to be infected and their contacts. In other words, get back to the containment phase, where more severe mitigation and suppression measures are no longer necessary.
Or it could just be that China is in the flat part of the curve in the middle of that top chart, and is mere weeks away from a flareup of infection rates, and reimposition of a lockdown. Everybody should have all eyes on what happens there, then, because it could determine whether the worst of this could be over soon — as YouTube Italians want to tell their past selves — or if this is just the very beginning of an unimaginably long slog.
There are many models out there. Our political system wont tolerate a lock down unless there are results. Back to normal in a few weeks
If the London report is correct, then “back to normal in a few weeks” means “and then 10% of Americans over 70 years old die.” Which would be a choice, I guess.
Not back to normal means an economic crash. Meaning 20% over 70 dies. How exactly are we pay for those ventilators if we have a run on the banks.
Where are you getting that 20% of people over 70 die in an economic crash? Death rates actually went down during the Great Depression:
https://www.pnas.org/content/106/41/17290
https://www.smithsonianmag.com/science-nature/great-depression-had-little-effect-on-death-rates-46713514/
If we’re under lockdown for as long as the eye can see but we don’t reach a peak any time soon and still have an economic disaster, we’ll have riots in the streets. Your faith in our society and its political system is a tad bit optimistic.
One prediction I’m now seeing is that we may be off lockdown by May sometime, but face a “roller coaster” of additional lockdowns the rest of this year and next as the virus flares back up again.
Sorry, left off the link:
https://www.nytimes.com/2020/03/17/opinion/coronavirus-social-distancing-effect.html
Based on these graphs it looks like we’re just delaying outbreaks of cases while costing a large number of working class people their livelihoods. A lot of people live paycheck to paycheck. Locking everyone down without pay for a long period of time might cause greater social issues than the virus itself. I suppose the government could compensate everyone to allow the purchase of neccesities but I also don’t think that is an effective long term solution either.
I understand social distancing in the short run is giving time to plan for medical and other responses but I don’t think it will work in the long run. Eventually people will either need to get the virus or receive a vaccine which a long ways off.
“Eventually people will either need to get the virus or receive a vaccine which a long ways off.“ – Yup. Either we wait a year or more (hopefully with periodic breaks in the lockdown for a month or two), or we let 2 million people die. It’s like an ethics puzzle!
10% of people over 70 sounds like pretty acceptable losses. that’s not very far from there thee year mortality anyway.
You do understand that the virus wouldn’t only kill people who were about to die anyway? So if 3.7 million people over 70 (plus lots of people under 70 with immune deficiencies, asthma, etc.) died from coronavirus, you’d still get the regular numbers of people dying from other causes as well.
Very interesting information, thanks.
It does beg the question “how long will those who run our economy will allow the lockdowns to continue?”
There will be major economic consequences, ones which no amount of federal aid is likely to offset (unless we are prepared to adopt the former Soviet Union’s monetary and productivity policies more fully than we already have…).
The “isolation” strategy is meant to get us through short term disruptions. It is not clear how or if it will work long term (the hoped for vaccine within 12-18 months is no sure thing, and the virus itself may have changed significantly by then).
I support the idea in the short term, if for no other reason than it will (hopefully) help to reduce the load on emergency and medical workers and the medical system itself. Hopefully this will allow us to avoid the decisions Italian medical professionals are now having to face (namely, to remove medical aid from an elderly person who needs it in order to provide same to a younger person in largely the same condition but with higher odds of survival). Essentially, mass triage… but with ongoing real time revisions as conditions require. Ugly stuff.
That said, it is still not clear to me that this will do anything in the long run beyond slowing the progress of the inevitable. Eventually, if there isn’t a working vaccine tested and applied in what seems like record time, most of the population is likely to have been infected.
For the sports world in particular, the ongoing benefits of cancelled games seems dubious. It is not at all clear that the players are less at risk through not playing than they would be otherwise (as ever, it depends what you do instead of playing, and how often you are checked/monitored when you aren’t playing as compared with when you are… we have already seen some professionals practicing and playing with rec league players in areas where rec leagues have not yet been shut down…). It seems most likely that games will resume, behind closed doors if necessary, at least for the world’s top leagues. If fans agree to “not” congregate outside stadia and are prevented from gathering in pubs or restaurants, this might be a viable solution. But will they?
Fans can (and do) pay to watch on tv. Networks pay regardless of whether fans are in the stadium or not. Broadcast revenues and rights fees are not inconsequential.
Agree/disagree? Thoughts?
A few thoughts:
“The ‘isolation’ strategy is meant to get us through short term disruptions.” — “Isolation” is technically a different thing, so let’s call it “suppression,” which is what the British researchers call it.
“That said, it is still not clear to me that this will do anything in the long run beyond slowing the progress of the inevitable. Eventually, if there isn’t a working vaccine tested and applied in what seems like record time, most of the population is likely to have been infected.” — If most of the population is infected in the next 12-18 months, there will be a massive death toll, because the medical system can’t handle that. That’s what the black line in the first graph above shows: We can end this fairly quickly by allowing everyone to get infected, but at the cost of 2.2 million deaths.
“we have already seen some professionals practicing and playing with rec league players in areas where rec leagues have not yet been shut down” — All rec leagues in NYC are shut down, and I expect that will be the case for the rest of the nation very soon.
“It seems most likely that games will resume, behind closed doors if necessary, at least for the world’s top leagues.” — That’s my thought as well, but it would have to be once infection rates are low enough that some easing of lockdowns is acceptable. And it could easily be interrupted again in case of a renewed flareup.
“It does beg the question ‘how long will those who run our economy will allow the lockdowns to continue?\'” — Like, will financiers eventually decide that grandma doesn’t have enough economic value to be worth saving? I guess it’s possible, though most of our nation’s business leaders are pretty aged themselves…
“Like, will financiers eventually decide that grandma doesn’t have enough economic value to be worth saving?”
Isn’t that what insurance and pension actuaries and HMO administrators literally do every day?
I’m not taking Matthew’s approach here, but there will be an ever increasing cost to trying to prevent something that seems likely to happen (though perhaps over a longer period of time) anyway.
And vis the financiers own age, I’m pretty sure they view their own lives as being far more valuable than those of poor 80 year olds in Mississippi and Arkansas.
To be clear, I am not saying it is right or just… only that it seems likely to happen unless a working vaccine is developed rather more quickly than everyone expects.
Here is my question? What is the latest MLB, NHL and NBA can return? I am going to guess July 4th for baseball and hockey Why? July is when NFL Training Camps open, and good luck with ice in places like Tampa Bay.
I would say around 2030. After that the kids of the current players would need to take their places.
https://www.sbnation.com/nba/2014/6/3/5772796/nba-y2k-series-finale-the-death-of-basketball
Even if China is successful, its approach can’t really be replicated. They placed an entire region under martial law with temperature checking points all over public spaces. If you registered a higher temp, you’re immediately pulled aside. If you test positive, immediate quarantine in a government facility. Good luck making that fly in the U.S.
I do think an immediate lockdown is necessary, but you can’t just handwave the economic impacts. Pointing out that death rates went down during the Depression is a bit obtuse, given that the average lifespan in the 1930s was around 60, and nowadays it’s around 78. A massive recession will impact the ability for a government to fund a response. Moreover, you can’t ignore the knock-on effect these shutdowns have. Who’s going to look after the kids of emergency and medical personnel, even under the “out for 1 month, in for 2” yo-yoing proposal? Who’s going to care for an elderly parent when their adult supports all lose their jobs because most hourly work has vaporized? At some point, I don’t think the decision will be made by the wealthy financiers; average working class folks are going to be willing to take the risk if it means getting an income again.
A more instructive parallel would be the London lockdowns during the Blitz of World War II. Yes, initially the country was locked down due to German bombing, but eventually they got on with living and learned to cope with the risks. There are stories of pub patrons having gas masks at the ready. More likely, we’ll see a return to a modified form of normalcy with measures in place to mitigate – but not completely eliminate – the threat. It’s almost impossible to model off what the future modified public behavior will be, but a sustained lockdown, or an intermittent lockdown with behavior modeled as if though we’ll all be prancing around in the intervening months of lockdown as though nothing has happened, is not in the cards.
I am kind of surprised we haven’t discussed massively intentionally infected the healthy and strong to quickly build up herd immunity.
Infect everyone under 35 with a strong immune system and then you can reopen society much quicker with less rapid spread.
“Was the abandoned British experiment an attempt to thread this needle, too?”
“Theirs was crazy. They said: let the virus run wild, but take all the older people who are super risky and somehow save them. Put them on an island. I don’t know how you do that—that’s part of the problem. Theirs was not a terrible idea if you could literally take everybody who was going to have a bad outcome and put them on an island and make sure none of them are infected. But no one knows how to do that. How do you prevent every older person from interacting with every younger person over a nine- or twelve-month period? It seems impossible to me.”
https://www.newyorker.com/news/q-and-a/the-coronavirus-and-building-a-better-strategy-for-fighting-pandemics