What is "the long haul"?
March 25, 2020 9:06 AM   Subscribe

Can you point me to sources that explain how long I should expect to stay at home? I would like to understand if we are staying until the top of the curve, the end of the curve, etc. I would like to read about how people will be making those decisions.
posted by aniola to Grab Bag (22 answers total) 9 users marked this as a favorite
This is an unprecedented outbreak and so there isn't a lot of information.

In addition, this isn't simply a medical or scientific matter, but also a social, political, and economic matter, where those will come into play as factors in determining the length of "stay at home" directives. Politicians are likely to have different risk/reward calculations than medical professionals.

I've been looking for this kind of information for some time now and haven't found anything particularly credible.
posted by jgreco at 9:10 AM on March 25 [1 favorite]

This previous AskMe collects sources: How long should social distancing last? (expert opinions on how long these measures need to last) (via the MeFi Wiki Disaster Planning & Recovery page, Medical/Pandemic section)
posted by katra at 9:16 AM on March 25 [3 favorites]

Unprecedented, no one can know, taking it hour-by-hour, et cetera.... Got it. Consider that aspect of my question covered.
posted by aniola at 9:20 AM on March 25 [4 favorites]

I have been hearing a lot of numbers about it but none of them talks less than "months" and I am talking about friends who work in the related industry.

Also, they add that what they are saying is the "we should" number (coming from experts), not necessarily the "we will" number (decided by politicians). I am from a developing country so your mileage may vary, or not.
posted by amar at 9:31 AM on March 25 [2 favorites]

You might find this Medium article Coronavirus: The Hammer and the dance informative. It sounds to me as if the timeframe really depends on how aggressively regions act to suppress the spread of the virus and how much testing they do to trace its spread. It seems like the results of widespread testing might be a big part of what would inform decision making, at least from the medical standpoint.
posted by kittydelsol at 9:45 AM on March 25 [12 favorites]

If we follow the model of South Korea and China, it takes at least two months of testing and self-isolation to contain the spread. Of course the US and most places are not as shut down as China, so it’s much harder to gauge. I’m personally trying to follow news from China as best I can - to the extent it’s possible to obtain news from China - to see what happens now that they’re supposedly lifting quarantine.
Bill Gates did an AMA on Reddit last week and he proposed 6-10 weeks of quarantine and testing is needed, which was based on what he thought is succeeding in China and South Korea. I’m keeping that number in mind because it helps my mental state to have a number to plan for.
posted by areaperson at 9:51 AM on March 25 [3 favorites]

This medium article seems to be very thorough. Just in case you haven't seen it yet.

And this Washington Post article (not paywalled) is a visualization of "the curve", but you probably already know about that.

From what I've read (i.e., I'm just some internet guy) it seems US challenges are wide enough testing and supporting our strained medical system.
posted by forthright at 9:55 AM on March 25 [1 favorite]

I have a quite pessimist view on this, so make allowances.

There are two possible answers. One is that the virus will continue to be a threat until a vaccine confers immunity to a large percentage of the population. That could be 18-24 months from now. Probably worst case, but the most certain.

The other possibility is that the threat diminishes until it's an acceptable risk before the vaccine. That would be some combination of a testing & isolation protocol (think South Korea), "herd immunity" from a lot of people getting sick and recovering, and/or some sort of miracle. Even the epidemiologists think something like this can happen because it has happened before with other viruses, but its completely out of sight at this time.
posted by SemiSalt at 10:28 AM on March 25 [3 favorites]

This doesn't give a specific schedule, but it's by a former director of the U.S. Centers for Disease Control and Prevention.
posted by NotLost at 10:29 AM on March 25 [1 favorite]

I’m an epidemiologist. When I heard about Britain’s ‘herd immunity’ coronavirus plan, I thought it was satire (William Hanage, Guardian Opinion, Mar. 15, 2020)
When I first heard about this, I could not believe it. I research and teach the evolution and epidemiology of infectious disease at Harvard’s Chan School of Public Health. [...] We talk about vaccines generating herd immunity, so why is this different? Because this is not a vaccine. This is an actual pandemic that will make a very large number of people sick, and some of them will die. Even though the mortality rate is likely quite low, a small fraction of a very large number is still a large number. And the mortality rate will climb when the NHS is overwhelmed. This would be expected to happen, even if we make the generous assumption that the government were entirely successful in restricting the virus to the low-risk population, at the peak of the outbreak the numbers requiring critical care would be greater than the number of beds available. This is made worse by the fact that people who are badly ill tend to remain so for a long time, which increases the burden.

[...] Is everyone in a high-risk group supposed to withdraw themselves from society for six months until they can emerge once the (so far entirely imaginary) second wave has been averted?

About that second wave: let me be clear. Second waves are real things, and we have seen them in flu pandemics. This is not a flu pandemic. Flu rules do not apply. There might well be a second wave, I honestly don’t know. But vulnerable people should not be exposed to a virus right now in the service of a hypothetical future.

[...] However, arguments about the case fatality rate, the transmission parameters and presymptomatic transmission all miss the point. This virus is capable of shutting down countries. You should not want to be the next after Wuhan, Iran, Italy or Spain. In those places, the healthcare systems have broken down. In Italy, the choices of whom to save and whom to allow to die are real. You should instead look to the example of South Korea, which, through a combination of intense surveillance and social distancing, appears to have gained some semblance of control over the virus. We can learn from South Korea, Singapore, Hong Kong and Taiwan, all of which have so far done a good job mitigating the worst outcomes despite having reported cases early in the pandemic, and in the case of South Korea, suffering a substantial outbreak.
posted by katra at 10:48 AM on March 25 [2 favorites]

From Ed Yong at The Atlantic: How will coronavirus end?
It’s likely, then, that the new coronavirus will be a lingering part of American life for at least a year, if not much longer. If the current round of social-distancing measures works, the pandemic may ebb enough for things to return to a semblance of normalcy. Offices could fill and bars could bustle. Schools could reopen and friends could reunite. But as the status quo returns, so too will the virus. This doesn’t mean that society must be on continuous lockdown until 2022. But “we need to be prepared to do multiple periods of social distancing,” says Stephen Kissler of Harvard. [...]

Whether through accumulating herd immunity or the long-awaited arrival of a vaccine, the virus will find spreading explosively more and more difficult. It’s unlikely to disappear entirely. The vaccine may need to be updated as the virus changes, and people may need to get revaccinated on a regular basis, as they currently do for the flu. Models suggest that the virus might simmer around the world, triggering epidemics every few years or so.
posted by LobsterMitten at 11:05 AM on March 25 [2 favorites]

Trudeau announced today a four month payment of $2,000/month from the government starting in mid April, which indicates that is around mid-August when they are thinking the Canadian society/economy will stabilize. In addition, it is widely held that schools are done for the year across Canada and will begin again in September. The previously mentioned the Hammer and the Dance explains how it will most likely play out (a series of waves of lifting restrictions and then re-imposing them). None of the pandemic plans I have reviewed over the past few years have specific timelines as it is such a dynamic situation.

I know the uncertainty is really hard to deal with, and it is also very regional (it is bizarre to me that some places in North America are “normal” as we enter our third week of lockdown) but if you are in North America I would not expect a return to anything close to normal until the summer and even then we will still be doing physical distancing and probably only limited public engagements.
posted by saucysault at 11:23 AM on March 25 [4 favorites]

I work for an essential business. We are currently working 100% remotely from home. My current mental time frame is 3 months before we can go back in the office. 18 months before the world at large is back to normal. My mental time frame is being continuously updated by paying attention to the Governor of my state (Ohio) and ignoring the Federal response.

That being said who knows if any of this will pan out. I personally am prepared to do whatever.
posted by dgeiser13 at 11:37 AM on March 25 [3 favorites]

I am totally just an observer watching the numbers, and this is the timeframe I have in my head.
I see the absolute minimum timeframe to stabilization of infections, IF we were to go full Chinese-style lockdown today (including food via community order) in the US, as 8 weeks out. That's May 20th.

Depending on what these wishy-washy "stay home" orders accomplish, I could easily see it lasting through the summer... or maybe even the end of the year or longer.
posted by stormyteal at 12:09 PM on March 25

I am not looking for mental time frames. I am looking for sources. I would like to read about how people will be making those decisions. Thanks!
posted by aniola at 12:22 PM on March 25

The Fox News whipsaw on coronavirus: In another swerve, hosts push Trump to abandon shutdown (Washington Post, March 24, 2020), on the three stages (thus far) of this administration's approach.
posted by Iris Gambol at 12:38 PM on March 25

Why Trump won’t have the final say on whether people go back to work (Amber Phillips, WaPo Analysis, Mar. 25, 2020)
Trump is the most powerful figure in the U.S. coronavirus response, and a large swath of the country supports him and will stand by him no matter what. And his voice certainly will play a role in how seriously all Americans treat social distancing, since it’s difficult.

But he alone can’t push Americans back to work and restart the economy. That’s for three reasons:

1. Governors are the ones ordering people to stay at home. [...]

2. In many states, schools are closed. [...]

3. Trump’s request that people avoid groups of more than 10 was just that — a request. [...]

In short, Trump’s guidance to America and how seriously he treats social distancing will certainly have an effect. But science and governors are moving in the opposite direction: more, not less, closing up.
posted by katra at 1:37 PM on March 25 [2 favorites]

The first thing to understand is that in the face of a Pandemic, basically Public Health has two options: Authoritarianism (laws restricting movement, restricting current civil rights) or Education (it is in your interest to be self-motivated to follow these directions for your own - and the community's, health). It also predicates an understanding of where your community falls on the individualistic --- collectivist spectrum and adjusting expectations accordingly.

Next, what is the larger goal, what is hoped to accomplish? Does your community/government want to minimize disruption and impact on businesses (if so, only certain businesses?), do they want to minimize the number of deaths, or the number of people who will be infected, have they decided that 1%, or 10% or 25%o f the population will disproportionately be affected while the others have minimal disruptions? If so, which 1% are going to be negatively affected? As well, governments are looking long term - how can they benefit based on their choices - and the choices other nations are making?

So, epidemiological studies will only take you so far, you have to have an understanding of your local government and community (because the government may make a decision that the community disagrees with and chooses a different way of dealing with the pandemic - including riots or simply en masse disobeying laws). There is a tonne of really interesting Public Health Pandemic Plans out there, many discuss the social/economic choices that will be made, but to be honest a lot of them pre-date the rise of deliberate misinformation/government mistrust/social disruption by bad actors like Putin. So the science can tell you a lot, but how your actual ruling government will decide to prioritize the options that scientists present to them is harder to predict.

I would suggest you google "Pandemic Plan [local geographic name]" to see the flow chart of decisions being made were envisioned to happen (caveat that the plans may have been approved under a different ruling party and often presume an influenza epidemic - which has been much more studied than coronaviruses have). This is Canada's Pandemic Plan, for example. There is a tonne more of papers available, look to see if your local university has a Public Health degree and if they have been publishing research in this area, as well as what your local Public Health Departments have been publishing themselves, following sources etc. to understand the framework beyond their conclusions.
posted by saucysault at 2:37 PM on March 25 [3 favorites]

Brown slams Trump administration over mask production woes (AP)
There is still no end date for the state’s stay-at-home order, Brown said.

“I am the governor of Oregon and my job is to protect the lives and health of Oregonians and one of the things I’m focused on is we have to make sure we have the ability to hospitalize those with COIVD-19 and we have to be able to provide beds,” she said. “That is going to be a key indicator for me of how long I keep the order in place.”
posted by katra at 6:39 PM on March 25 [1 favorite]

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