How long can we wait while flattening the curve?

[Telecaster]

https://www.washingtonpost.com/investigations/2020/04/27/covid-19-death-toll-undercounted/?arc404=true

Washington Post research more or less cosigns the NYTimes stuff on excess mortality.

Something is killing people in March/April of 2020 in the United States.

The interesting thing to me is that if they are COVID-19 deaths but not "obviously" COVID-19 then this coronavirus is finding ways to make people ill that are not recognised as serious symptoms - it's doing something other than the classic lung infection and that other something kills people.

Frightening article in Science Magazine on this topic:

Despite the more than 1000 papers now spilling into journals and onto preprint servers every week, a clear picture is elusive, as the virus acts like no pathogen humanity has ever seen.

https://www.sciencemag.org/news/2020/04/how-does-coronavirus-kill-clinicians-trace-ferocious-rampage-through-body-brain-toes#

[jehovasfitness23]

Yeah, fuck all the obese people and people with diabetes, etc. Especially the poor ones living in food deserts, and without decent medical care, and no access to a gym, or money to afford a membership, and no one who knows about fitness or cooking to teach them better habits. Fuck ‘em all. I got mine.

I am seriously, honestly, terrified.  My stepfather is immuno-compromised (going through regular cancer treatment) and an obese diabetic.   He's been dealing with diabetes for decades, but handling that while living alone, unable to exercise, after 18 months of cancer treatment (and regular trips to the hospital for treatment) is fucking hard.  He's not lazy, stupid, or unworthy of medical care.  (In fact he has great insurance from his pension and his treatment over the last few years has probably been at least half a million bucks.)

"Knowingly living a bad lifestyle" - that guy can just fuck right off.  People get sick and have co-morbidities that have nothing to do with being unworthy, lazy, or terrible people.  Read a few books dude.

I took the comment as sarcasm

[boy_bye]

I would also caution people from thinking they everything about "obesity" as a "co-morbidity." Folks are making wild assumptions based on very tiny and conflicting data sets and at this point it's basically just showing up as anti-fat bias and it ain't a good look.

https://www.wired.com/story/covid-19-does-not-discriminate-by-body-weight/

[dandarc]

I took the comment as sarcasm

This is why we need sarcasm font.

I'm sure all our "OPEN EVERYTHING RIGHT NOW" posters would be convinced if the sarcasm was clear.

[T-Money$]

I would also caution people from thinking they everything about "obesity" as a "co-morbidity." Folks are making wild assumptions based on very tiny and conflicting data sets and at this point it's basically just showing up as anti-fat bias and it ain't a good look.

https://www.wired.com/story/covid-19-does-not-discriminate-by-body-weight/

The few brain cells I had left started dying when I read "structural racism", "disproportionately impacting" and "systemic inequalities".  The opinion piece read like an echo chamber for identity politics. I'm not sure political agendas have a place in medical studies?  Anyway...

https://www.nytimes.com/2020/04/23/health/coronavirus-patients-risk.html

As someone who has struggled with weight and hypertension in my life I learned there is a big difference between empathy and enabling.  It's human to care about people and understand part of our condition is suffering, it's worthwhile to offer help.  But it's toxic to enable someone's self-sabotaging behavior.  If you shield someone from the consequences of their action, they are more likely to not be able to learn about the real impact of their behavior and choices -- they are much more likely to rely on others for their physical and emotional needs.  That comes with a huge cost.

As someone who has been "fat" and could very easily be "fat" again if I'm not extremely careful, being "fat" is never, ever healthy.  It causes significant problems with avoidable conditions, it increases risks of various cancers and almost guarantees cardiovascular disease and a premature death. 

I will not shield anyone from the consequences of their action, especially at the expense of my own health and family.

The Wired article also claims asthma could cause a worse outcome (something I have), but that isn't the case:

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30167-3/fulltext

https://www.aaaai.org/conditions-and-treatments/library/asthma-library/covid-asthma

(As a side note, if you have asthma and are sick of the side effects of steroids consider a natural technique called "Buteyko")

https://www.nytimes.com/2009/11/03/health/03brod.html

[Cassie]

I am sick of people claiming that all chronic conditions are lifestyle related. Most people on my mom’s side of the family got HBP around 31 despite being in great health. They were born in the 1920’s when people grew their own food, exercised and did everything right. The whole family except my grandma was health conscious. I developed asthma, HBP and a too fast erratic heart rate at 50 when I was in great shape.  One day I was walking 8 miles a day and the next being told it was a miracle I hadn’t had a stroke.  2 of my son’s have HBP at 31 and 47 despite doing everything right. One of my son’s had asthma by age 1. As a former social worker I realize that stuffing poor people in overcrowded conditions is a recipe for disaster in many ways. I would guess that in the next 2-4 weeks things will open slowly and eventually everyone will get it like the flu or colds.  We can’t stay locked down forever. It was the right thing to do to not overwhelm the HC system.  I imagine people will die every year from it and we will adjust because we have no choice.

[js82]

I would also caution people from thinking they everything about "obesity" as a "co-morbidity." Folks are making wild assumptions based on very tiny and conflicting data sets and at this point it's basically just showing up as anti-fat bias and it ain't a good look.

https://www.wired.com/story/covid-19-does-not-discriminate-by-body-weight/

The few brain cells I had left started dying when I read "structural racism", "disproportionately impacting" and "systemic inequalities".  The opinion piece read like an echo chamber for identity politics. I'm not sure political agendas have a place in medical studies?  Anyway...

https://www.nytimes.com/2020/04/23/health/coronavirus-patients-risk.html

Sorry, but this needs to be called out - if we're going to be intellectually rigorous here, we can't just talk correlations(without causation) and anecdotes - we need actual evidence of impacts of *specific* comorbidities, not just an "oh, most people who were hospitalized had comorbidities"  Saying "most patients had comorbidities" isn't really a useful statement - especially not when most fatalities are in the 60+ age bracket to start with, and most people in that bracket have some kind of "preexisting condition" purely due to their age.

Factual(Data-based) Statements:
1. 89% of coronavirus fatalities in New York were patients with a "comorbidity"
2. However, Several of the top "comorbidities"(most obviously hyperlipidemia and Dementia) are irrelevant - these clearly aren't going to aggravate a respiratory illness by themselves.
3. The #1 "comorbidity" for Covid-19 deaths was Hypertension; however 63% of adults in the US over the age of 60 have hypertension.  If you look at New York State data for coronavirus deaths, the incidence of hypertension in age 60+ deaths is... 60.5%.  Not a lot of evidence to say that individuals with hypertension are dying from Covid at a grossly higher rate than the population at large due to that factor alone.
4. On the other hand, Diabetes is clearly overrepresented (38% of Covid deaths 60+ vs. 21% of 65+ population).  Renal Disease is overrepresented as well, particularly among younger fatalities.  There's pretty strong evidence that these conditions *do* increase someone's risk of dying with Covid.

Source: https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Fatalities?%3Aembed=yes&%3Atoolbar=no&%3Atabs=n

Saying it's only people with preexisting conditions who die of Covid-19 is intellectually lazy - because many of those preexisting conditions simply don't matter - and the overwhelming majority of age 60+ Americans have some sort of "preexisting condition" even if relatively healthy for their age - though once again, many of these conditions aren't necessarily relevant to the discussion.  The discussion needs to focus on the risk from specific complicating factors.

[T-Money$]

I would also caution people from thinking they everything about "obesity" as a "co-morbidity." Folks are making wild assumptions based on very tiny and conflicting data sets and at this point it's basically just showing up as anti-fat bias and it ain't a good look.

https://www.wired.com/story/covid-19-does-not-discriminate-by-body-weight/

The few brain cells I had left started dying when I read "structural racism", "disproportionately impacting" and "systemic inequalities".  The opinion piece read like an echo chamber for identity politics. I'm not sure political agendas have a place in medical studies?  Anyway...

https://www.nytimes.com/2020/04/23/health/coronavirus-patients-risk.html

Sorry, but this needs to be called out - if we're going to be intellectually rigorous here, we can't just talk correlations(without causation) and anecdotes - we need actual evidence of impacts of *specific* comorbidities, not just an "oh, most people who were hospitalized had comorbidities"  Saying "most patients had comorbidities" isn't really a useful statement - especially not when most fatalities are in the 60+ age bracket to start with, and most people in that bracket have some kind of "preexisting condition"

Factual(Data-based) Statements:
1. 89% of coronavirus fatalities in New York were patients with a "comorbidity"
2. However, Several of the top "comorbidities"(most obviously hyperlipidemia and Dementia) are irrelevant - these clearly aren't going to aggravate a respiratory illness by themselves.
3. The #1 "comorbidity" for Covid-19 deaths was Hypertension; however 63% of adults in the US over the age of 60 have hypertension.  If you look at New York State data for coronavirus deaths, the incidence of hypertension in age 60+ deaths is... 60.5%.  Not a lot of evidence to say that individuals with hypertension are dying from Covid at a grossly higher rate than the population at large due to that factor alone.
4. On the other hand, Diabetes is clearly overrepresented (38% of Covid deaths 60+ vs. 21% of 65+ population).  Renal Disease is overrepresented as well, particularly among younger fatalities.  There's pretty strong evidence that these conditions *do* increase someone's risk of dying with Covid.

Source: https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-Fatalities?%3Aembed=yes&%3Atoolbar=no&%3Atabs=n

Saying it's only people with preexisting conditions who die of Covid-19 is intellectually lazy - because many of those preexisting conditions simply don't matter - and the overwhelming majority of age 60+ Americans have some sort of "preexisting condition" even if relatively healthy for their age - though once again, many of these conditions aren't necessarily relevant to the discussion.  The discussion needs to focus on the risk from specific complicating factors.

Do we know enough about COVID-19 to say what co-morbidities are relevant and which aren't?  It seems like we can only make correlations at this point, causation will likely come along with more data and research.  Who is to say which preexisting conditions matter and which don't?  Talk about being intellectually lazy.  The data is showing something we may be able to learn about COVID-19 but because it doesn't fit the way you see the world you are discarding it as "doesn't matter" "not relevant". 

Renal disease and type 2 diabetes are strongly correlated with obesity.

It's a weird world we live in.  Alcoholism is likely influenced by genetics.  It isn't someones fault they are an alcoholic, but it becomes their responsibility.  If they drink too much at the wrong time they could injure themselves or others, if they continue abusing alcohol it can kill them.  It's illegal to consume alcohol in many situations, and if caught alcoholics can go to jail for a long time.

Obesity is likely influenced by genetics.  It isn't someones fault, but it becomes their responsibility.  They are the ones that have to live with the complications from the illness.  Like alcoholism, this causes a lot of problems and costs for society, reduces life expectancy, takes up resources, but it could be avoided.

Both cause health problems because of excess consumption.

One is not accepted, but the other largely is accepted -- in fact I could argue one of them is "politically correct".

Ever try to mention to an alcoholic they are drinking too much, you are concerned about their health, and you are afraid they are putting themselves at risk?  You know what they will say to you (even though you are caring and are empathetic)?

Hmm, this COVID discussion is becoming awfully familiar. 

There have been 6 deaths in NYC of those over age 65 that had no pre-existing conditions.  There have been close to 6,000 deaths of those over age 65 that had pre-existing conditions.  I know many very healthy seniors in New York City -- they will be fine and dandy.  Pre exisiting conditons cause COVID death, denial ain't a river in Egypt.

And no, not all pre-existing conditions are due to lifestyle choice, but a lot of them are.  A lot of our current situation could be avoided if our culture was different.

[Kyle Schuant]

I am sick of people claiming that all chronic conditions are lifestyle related.

Nobody says they are. What we say is that,

1. lifestyle factors can make chronic conditions more likely, and
2. if you already have a chronic condition, your lifestyle can impact whether it comes on sooner or later, how severe it is, and whether it inconveniences or kills you.

There is always some unique special snowflake who does everything right and keels over anyway. Likewise, there is always some bastard who does everything wrong and lives to 100. But generally speaking, our behaviour tends to lead to certain results. Most of us here understand the power of compound interest, that gradually increasing debt can ruin us, and gradually increasing investments can make us. That some people win the lottery and others have their house burn down does not change the fact of what are and are not good financial habits. Most of us are not unique special snowflakes. Our behaviours, good or bad, likewise compound over decades.

[AnnaGrowsAMustache]

I am sick of people claiming that all chronic conditions are lifestyle related. Most people on my mom’s side of the family got HBP around 31 despite being in great health. They were born in the 1920’s when people grew their own food, exercised and did everything right. The whole family except my grandma was health conscious. I developed asthma, HBP and a too fast erratic heart rate at 50 when I was in great shape.  One day I was walking 8 miles a day and the next being told it was a miracle I hadn’t had a stroke.  2 of my son’s have HBP at 31 and 47 despite doing everything right. One of my son’s had asthma by age 1. As a former social worker I realize that stuffing poor people in overcrowded conditions is a recipe for disaster in many ways. I would guess that in the next 2-4 weeks things will open slowly and eventually everyone will get it like the flu or colds.  We can’t stay locked down forever. It was the right thing to do to not overwhelm the HC system.  I imagine people will die every year from it and we will adjust because we have no choice.

People love to believe that all events are within their control. It means that their good decisions are responsible for their good health/finances etc, while other people's bad decisions are responsible for their health/finances etc. It's a way of interpreting the world that gives people a sense of order. Unfortunately, it's false. The pandemic should be demonstrating that to everyone, and it's why some people need to double down on the idea that people cause their own death somehow. It means they might have control over their own fate. No one does. Of course, there are decisions that people make that shift their possibilities in one direction or another, but actually luck plays a huge role in lives. But that's scary, innit? Some people don't cope well with scary.

[Kyle Schuant]

Of course not everything is under our control. But there is no sense worrying about the factors which are [/i]not[/i] under our control, since by definition there is nothing we can do about them. Instead we worry about and then act on the factors which are under our control.

[Bloop Bloop]

Here is an example of the abject hypocrisy which I object to. Our premier today demanded that our aged care centres allow family visitors. He said that with strict hygiene measures this posed an acceptable risk.

Now...in Victoria, we are not allowed to:
- Visit family who do not live in the same household
- Drive recreationally
- Go fishing
- Go golfing
- Go hiking

Yet he wants family visitors to be able to visit aged care residents despite that being:
- The most vulnerable group in the state?
- The largest single source of infections (besides an overseas cruise ship) in the state?
- Risky not just for residents but for the aged care employees?
- Against a lot of the aged care homes' preferences (they themselves don't want visitors)?

Does anyone see how fucked this is, and how this shows that politicians only care about image and not actual rationale?

Premier Daniel Andrews has said some nursing homes risk eroding public trust in the aged care sector even further if they continue disallowing visitors.

Some private aged care centres have enforced hard lockdowns where elderly people cannot receive visitors, sparking community anger from families.

[Little Aussie Battler]

I see the inconsistency, but I'm not sure I see the hypocrisy.

My immediate assumption when I saw that was that they are worried about the increased likelihood of residents being mistreated/abused if the centres are not open to visitors.

[Gremlin]

Aged care is a managed by the federal government, all the other things on Bloop Bloop's list are under state jurisdiction.  So inconsistent between the two levels of government but hardly hypocrisy on behalf of Andrews.

In other news today, Newspoll released results of their latest poll.  It included a question regarding the State Premiers handling of Covid-19

Andrews (VIC) - 85% well, 11% badly
Berejiklian (NSW) - 77% well, 18% badly
Palaszczuk (Qld) - 72% well, 23% badly
Marshall (SA) - 82% well, 11% badly
McGowan (WA) - 94% well, 4% badly
Gutwein (Tas) - 89% well, 8% badly

What struck me is that those numbers don't have anything like the partisanship you normally see in political polls.  That highlights to me that the very vast majority think that Australia is on the right path.

[Kyle Schuant]

Yep, and watch how the numbers change in October when the Commonwealth handouts stop.

[Holocene]

Almost all of the “unknown” column have eventually been put into the “known” column since the pandemic began.  How that is done I don’t know (but I’m interested to find out), so therefore I included them as known since it seems that’s how things have gone in the past.

Regarding the pre-conditions, obesity is obviously preventable, type 2 diabetes is about 90% preventable and essential hypertension about 85% preventable.  Those are huge numbers of risk factors that could be avoided. 

As for the government policies and their unlikelihood to be followed in the future, increasingly people do not have an incentive to follow them.   Without a job or healthcare, what’s the point to do anything the government advocates?   The elderly and ill demand society destroy itself so they can reduce their risk, yet the ability of society to take care of those economically and mentally effected isn’t even discussed.  Not once have I heard what the government is going to do for those that have lost their jobs and healthcare. 

For most people the consequences of the reaction are much worse than the risks from the virus — which is exactly why the stay-at-homes are ending.  There is no longer an incentive to follow them.

Also, without opening up things like parks and schools and moderating policy at least a bit, having objective standards about when to allow businesses to open — policy is less likely to be followed.   It’s through the governments own hysteria, irrationality and short-sightedness that these policies will fail. 

Society can only do so much to reduce the risks of preventable illness and pre-conditions, and locking up the healthy and children seems immoral and inhumane.  At some point there needs to be an acceptance that the way we choose to live has a significant outcome on our overall health.  I think there is a more appropriate middle ground the government could take at reducing the risks, yet also maintaining the economy and rights for those that are healthy.  The government hasn’t done that, so it’s time to end the “plan”.

BiB: I'm not sure what point you are making here: a different lifestyle can avoid most of those issues but not in the timescale of this pandemic.

You seem to suggest that the obese, the type 2 diabetic and the hypertensive are not worthy of having their health protected from a pandemic, and/or that the healthy should not be put to any inconvenience to protect them.
 
That's a pretty jawdropping attitude.

I'm glad I'm not the only one whose jaw dropped at this statement.  I mean, I understand the economic argument and can understand that those most impacted by this are not the ones privileged enough to argue about it here but those in the situations waltworks was describing. We can argue about which method may bring about more harm (lockdown vs. looser restrictions vs. letting the virus run free).  But I'm still amazed at the crazy implication egillespie seems to be making.  One, because there are a lot of people who may be at higher risk through no fault of their own for various reasons.  And two, because even if someone made poor decisions in the past and have struggled with weight, food addiction, motivation to exercise, etc. and is for whatever reason at a higher risk due to some self-inflicted reason, I still think they deserve protection from society.  To say screw them, they brought it upon themselves...that's just callous.  I know I for one would hate for my life to depend on having made perfect decisions for my entire life.  I'm sure we've all made poor decisions at some point.

To the other point I underlined re: what the government is gonna do about lost jobs/healthcare, isn't this exactly what's being addressed in multiple coronavirus relief bills of >$2T?  You make it sound like the government is doing nothing for those who have lost their jobs.  They're giving everyone (under a certain income) a check ASAP to try and help with some immediate relief.  They've expanded unemployment.  In most cases, I believe losing your job is a qualifier for signing up for ACA health coverage or possibly Medicaid.  To me, it seems like a lot of workers would be better off being able to stay at home and collect unemployment and be safe, rather than having to go into work at a crowded place (ie. mall, restaurant, casino) and risk their health for a paycheck.  I'm not one of those people who has to make that decision though and I'm not in a situation where I'd be broke if I didn't work, so I could be wrong.  I think even if places open back up, at the very least people should still be able to collect unemployment if they're not willing to risk their lives to go back to work.

I get that we can't live in lockdown mode forever.  State and local governments are working hard to figure out ways that make sense to start opening things up while still keeping it as safe as possible.  Basically, we needed to lockdown to give ourselves time to gather and analyze information about this virus and prepare our hospitals.  Now we can start bringing non-essential business back up in ways that are lower risk for everyone, workers and customers.  It's a delicate balance, but erring on the side of tighter lockdowns until we fully understand the implications seems smart.  We don't get a re-do and it generally takes weeks before we see the impacts of our actions show up in the numbers (cases and especially deaths).  Ask Italy and NYC if they'd prefer to have locked down earlier...

[Bloop Bloop]

What struck me is that those numbers don't have anything like the partisanship you normally see in political polls.  That highlights to me that the very vast majority think that Australia is on the right path.

People were happy with the US government's handling of 9/11 as well. Communities band together in crisis. That doesn't mean that the government has made good economic/policy decisions. As Kyle said, wait till the double Centrelink and Job Keeper go away.

And it must be said that the $200b we've borrowed has to come from somewhere, and that money represents lost utility as well.

[Holocene]

Now...in Victoria, we are not allowed to:
- Visit family who do not live in the same household
- Drive recreationally
- Go fishing
- Go golfing
- Go hiking

Bloop Bloop, I think even most of us "pro-lockdown" people agree with you for the most part.  It sounds like your lockdown has been harsher than most places in the US.  I'm allowed to do all of these things you listed except technically the first one, though nothing seems especially enforced in my state.  We're supposed to practice social distancing as we do any activity.  I honestly don't see how driving recreationally would increase the risk of spread, so that one seems odd to me.  A lot of national parks, beaches, bike paths, and hiking trails in the US were closed because they got too crowded and people weren't able to adequately social distance.  Maybe Australia is trying to avoid that from happening and just banning everything.

From what you've described, it sounds like your state could relax the restrictions a bit but not completely lift them.  If they keep them months after you no longer have any new cases, then yeah, I'd understand your frustration.  But it's still early in this thing, and what's being done seems to be working there, so keeping it up doesn't seem crazy to me in the immediate future.  I'd say it's been especially worth it for your country, as your lockdown may have been early and harsh enough to have prevented thousands of deaths.  You don't want to lift too soon and reverse the weeks you've already endured.

In contrast, my state in the US has been on an official stay at home order for 1 month.  This order allows essential businesses to continue to run and in the last week or two have been putting guidelines into place for allowing more non-essential businesses to start opening.  We're allowed to go outside to exercise and go to the stores (grocery, pharmacy, hardware).  But still, despite being in lockdown this whole time, our cases and deaths continue to increase.  Had we not closed things down as early as we did (before it really looked that bad), we'd be on a much worse trajectory.  The exponential growth of this virus is a scary thing.  Having a cautious approach makes more sense.  You can always lift restrictions early.  You can't go back in time and make them harsher.

Numbers for my state:
March 27: ~400 confirmed positive cases, average of 50-60 new cases per day, 4 total deaths
April 27: ~3800 confirmed positive cases, 214 new cases today, 286 total deaths

[Abe]

Oxford reports they have good preliminary data on efficacy of their covid vaccine in monkeys (very limited samples size of 6, but none were sick at 4 weeks after extremely high doses of virus). They’re Going to start phase 1 trials in UK within a week or two, then expand to randomized trials over the summer if safe.

[aspiringnomad]

Oxford reports they have good preliminary data on efficacy of their covid vaccine in monkeys (very limited samples size of 6, but none were sick at 4 weeks after extremely high doses of virus). They’re Going to start phase 1 trials in UK within a week or two, then expand to randomized trials over the summer if safe.

It's promising. Randomized trials actually already started last week. They're calling it Phase 1 but it's over 1,000 participants because they already know it's safe from prior usage of a similar vaccine developed in response to MERS. But it is a double blind trial for effectiveness and the first recipients received either the vaccine or a placebo last Thursday. Future phases will expand participant age and other demographics but if data comes in showing effectiveness they have plans and funding to spool up production immediately and before emergency regulatory approval.

[Kyle Schuant]

And it must be said that the $200b we've borrowed has to come from somewhere, and that money represents lost utility as well.

Actually... $379.8 billion, at least.

A casual google search... some of these are from a month ago, though, there's probably more spending since then.

Commowealth: $320B [https://treasury.gov.au/coronavirus]
NSW: $3.3B ($2.3B here, plus another $1B on public housing planned) [https://www.abc.net.au/news/2020-03-17/nsw-government-reveals-2.3-billion-coronavirus-stimulus-package/12061322]
Qld: $4B [https://www.treasury.qld.gov.au/programs-and-policies/covid19-package/]
SA: $1B [https://www.premier.sa.gov.au/news/media-releases/news/$1-billion-stimulus-package-to-save-sa-jobs,-businesses]
Tas: $1B [https://www.abc.net.au/news/2020-04-27/economic-future-for-tasmania-state-of-states-coronavirus/12187220]
Vic: $49.5B [https://www.abc.net.au/news/2020-04-16/coronavirus-victoria-schools-term-2-update-covid-19-cases/12151790]
WA: $1B [https://www.abc.net.au/news/2020-03-31/wa-coronavirus-household-business-bill-relief-package-explained/12107856]

That's 26% of GDP, altogether. Well... the pre-lockdown GDP, anyway. Of note: normal commonwealth government spending is about 24% of GDP. So altogether government spending will be half the economy. That's very Scandanavian. No atheists in foxholes, and no free market capitalists in a crisis :)


The Vic money is mostly for big infrastructure projects, so a good chunk of it will go overseas to foreign companies, engineers, etc. The Commonwealth money... well, we're not allowed out so we can't really spend it on much... Obviously the poorer people will spend it all on ordinary old groceries and consumer goods, which is good for the economy and for them, but the rest of us? I guess people will save it or whack it on their mortgage. Nice for the banks.

I don't have a problem with going into debt as such, so long as what we're spending it on builds the country in some way, and doesn't just go to foreign multinationals or buy cheap Chinese junk. But the fact is that at some point the debt has to be repaid, which means either less services or higher taxes. And nobody ever got elected promising less services and higher taxes, so it tends not to get repaid. Which eventually makes things messy.


Rather than tearing things down then borrowing to build them up again, I would rather just not tear things down in the first place. This applies whether the tearing down comes from such pernicious policies as free trade and economic rationalism, or from well-meaning things like the virus response. Again: in the first weeks it was probably necessary, and we didn't know what worked and what didn't so we had to go hard. But now we know.


And again, what works when you do it early on, as Australia did, may or may not work when you wait till 10,000 people are already infected, like other countries did. If you wait till the roof caves in to call the fire department, it doesn't really matter how good the firemen are.

[cerat0n1a]

https://www.washingtonpost.com/investigations/2020/04/27/covid-19-death-toll-undercounted/?arc404=true

Washington Post research more or less cosigns the NYTimes stuff on excess mortality.

Something is killing people in March/April of 2020 in the United States.

The interesting thing to me is that if they are COVID-19 deaths but not "obviously" COVID-19 then this coronavirus is finding ways to make people ill that are not recognised as serious symptoms - it's doing something other than the classic lung infection and that other something kills people.

Some (fairly scary) stuff on this here:

https://nymag.com/intelligencer/2020/04/we-still-dont-know-how-the-coronavirus-is-killing-us.html

as well as here:

https://www.sciencemag.org/news/2020/04/how-does-coronavirus-kill-clinicians-trace-ferocious-rampage-through-body-brain-toes

[ROF Expat]

If there is anything we should take from this experience, it's that "the experts" cannot be blindly trusted to figure out the best solution new problems. All those people collecting paychecks from the CDC, WHO, FDA, and so on, and still the worst thing that could happen.. happened. "Centers for Disease Control and Prevention."  Yeah, how's  the working out? They didn't prevent or control anything. Their solution is to impose house arrest on the entire world. Absolutely abysmal failure on every level. I hope we fire all of them when this is over.
[/quote]

CDC, WHO, and FDA are made up of people, and sometimes people make mistakes, particularly when they're addressing new problems.  I think there's evidence that those organizations (and others) could have handled the coronavirus outbreak more effectively.  I'm confident they're assessing the effectiveness of their current efforts and trying to adjust on the fly.  When this is over, key decisions and actions will have to be carefully analyzed after the fact so that lessons can be learned. 

Simply assigning all blame to "the experts" and calling for them all to be fired seems to me to be both short-sighted and counterproductive.  Science and expertise may be imperfect, but they are the best resource we have.  You may not think much of CDC, WHO, and FDA, but they exist for a reason and if they didn't exist we'd recreate something much like them.  It is appropriate to focus on these organizations' problems, but it is only fair to look at their successes as well.  CDC was founded in 1946 and it isn't a coincidence that diseases like Polio. measles, and whooping cough that were common then aren't common now.  FDA was founded in 1906 and issues like intentionally adulterated food, lack of drug standards, and medical quackery aren't the common problems they once were.  I am grateful for "experts" like Frances Oldham Kelsey who refused to approve thalidomide for use in the US despite pressure from the drug company and the fact that it had already been approved for use in other countries.  I am similarly grateful to the anonymous scientists and doctors at FDA and CDC today who resist pressure to approve drugs without scientific evidence and work to make my life better.  Life expectancy is up globally because of these "experts" and the scientific principles that guide them. 

I have lived in countries that don't have a strong equivalent of FDA.  You learn to appreciate what FDA does when your doctor warns you that the drugs sold in the local pharmacies might well be counterfeits with no active ingredients, wildly varying amounts of active ingredients,  or even dangerous additives.  I have lived in countries without a strong equivalent of CDC.  In those places, I am happy to see WHO providing advice and assistance. 

I think regulatory agencies are like umpires and referees.  We don't like it when a ref makes a bad call against our team (by definition "bad" calls are against us.  We never trash the ref for a call that goes our way...) but without refs, how long would it take for competitive sports to degenerate into a brawl and become unplayable?  There are things to criticize and improve in agencies like FDA and CDC, but there's no question in my mind that what they (and the experts that staff them) add to our lives is far more positive than negative. 

I agree with your statement that scientists and experts "cannot be blindly trusted to figure out the best solution."  COVID is an economic problem as much as it is a medical problem.  I wouldn't ask an epidemiologist to provide the whole solution any more than I would ask an economist.  Our political leaders are supposed to draw on the knowledge of experts from all the appropriate fields, weigh their options, and synthesize a solution.  Then we hold our political leaders responsible for the result. 

My vision of a world without "experts" looks a lot like the movie "Idiocracy." 

[mathlete]

Texas will let the stay at home order expire at the end of the month and phase in a reopening.

Not a bad state to start with as infections and deaths per capita are rather low. Hopefully we get some good data here.

[T-Money$]

https://twitter.com/NateSilver538/status/1254130268732100609

[somebody8198]

The government might not do it but it's sensible public policy to value lives unequally.

Depends upon what the public thinks IMO. And the US Government value of a statistical life attempts to quantify how much the public values life. If there's enough push back, then that says something about the value of life, and the government should rethink the lockdown and the calculation.

Even so, that's a little problematic from a civil liberties perspective. I've seen a lot of argument on the anti-lockdown side regarding civil liberties. But life is also a civil liberty, and in the Declaration of Independence, one of my country's most cited documents, it's actually listed before liberty, and the pursuit of happiness.

People trade their own life for liberty and the pursuit of happiness all the time when they take up smoking or skydiving. But since this is a public health crisis, we're talking about trading others lives for our liberty and pursuit of happiness. Or the other way around.

We're talking bout a large number of lives and an even larger number of persons having their pursuit of happiness impacted. It's a tricky situation and we gotta be careful and get it right. Having studied this for months, I think the US response is decently close to "getting it right". And this is coming from someone with absolute contempt for the person in charge right now. No matter how many mind-numblingly stupid things he says though, it's clear to me that really smart people on both the public health side and the economics side are driving the discourse.

Trading other people's lives for the liberty and pursuit of happiness has obvious precedent in the US doesn't it? Didn't the draft send tens of millions of young people into harm's way, with hundreds of thousands dying and many, many more suffering life-long repercussions as a result? All to protect the opportunities for the majority of the population to enjoy liberty and pursue happiness.

People are protesting their businesses being shut down, or being unable to plant seeds to grow food on their own property (see: Michigan). If you think they are protesting some nebulous concept of "lockdown" you're being willfully ignorant. "It's the economy, stupid." And boy it there a lot of stupid on this forum.

[OtherJen]

The government might not do it but it's sensible public policy to value lives unequally.

Depends upon what the public thinks IMO. And the US Government value of a statistical life attempts to quantify how much the public values life. If there's enough push back, then that says something about the value of life, and the government should rethink the lockdown and the calculation.

Even so, that's a little problematic from a civil liberties perspective. I've seen a lot of argument on the anti-lockdown side regarding civil liberties. But life is also a civil liberty, and in the Declaration of Independence, one of my country's most cited documents, it's actually listed before liberty, and the pursuit of happiness.

People trade their own life for liberty and the pursuit of happiness all the time when they take up smoking or skydiving. But since this is a public health crisis, we're talking about trading others lives for our liberty and pursuit of happiness. Or the other way around.

We're talking bout a large number of lives and an even larger number of persons having their pursuit of happiness impacted. It's a tricky situation and we gotta be careful and get it right. Having studied this for months, I think the US response is decently close to "getting it right". And this is coming from someone with absolute contempt for the person in charge right now. No matter how many mind-numblingly stupid things he says though, it's clear to me that really smart people on both the public health side and the economics side are driving the discourse.

Trading other people's lives for the liberty and pursuit of happiness has obvious precedent in the US doesn't it? Didn't the draft send tens of millions of young people into harm's way, with hundreds of thousands dying and many, many more suffering life-long repercussions as a result? All to protect the opportunities for the majority of the population to enjoy liberty and pursue happiness.

People are protesting their businesses being shut down, or being unable to plant seeds to grow food on their own property (see: Michigan). If you think they are protesting some nebulous concept of "lockdown" you're being willfully ignorant. "It's the economy, stupid." And boy it there a lot of stupid on this forum.

No one is being prohibited from planting seeds on their own property in Michigan. We and many others have already started seedlings, and seeds are available for purchase from local hardware stores, some grocers, and via mail order. Probably also via curbside at Home Depot, as that's how we purchased some of our starter supplies. Guess what, we can also cut our own grass. Stop listening to Fox News.

Besides, anyone who lives here knows that no new plants go in the ground before Mother's Day because it will probably freeze and be killed.

Edited to add that as of yesterday, there are no restrictions on what big box stores can sell in-person. Anyone can now walk into Meijer/Walmart/Home Depot/Lowe's and buy whatever garden supplies they want.

[GuitarStv]

The government might not do it but it's sensible public policy to value lives unequally.

Depends upon what the public thinks IMO. And the US Government value of a statistical life attempts to quantify how much the public values life. If there's enough push back, then that says something about the value of life, and the government should rethink the lockdown and the calculation.

Even so, that's a little problematic from a civil liberties perspective. I've seen a lot of argument on the anti-lockdown side regarding civil liberties. But life is also a civil liberty, and in the Declaration of Independence, one of my country's most cited documents, it's actually listed before liberty, and the pursuit of happiness.

People trade their own life for liberty and the pursuit of happiness all the time when they take up smoking or skydiving. But since this is a public health crisis, we're talking about trading others lives for our liberty and pursuit of happiness. Or the other way around.

We're talking bout a large number of lives and an even larger number of persons having their pursuit of happiness impacted. It's a tricky situation and we gotta be careful and get it right. Having studied this for months, I think the US response is decently close to "getting it right". And this is coming from someone with absolute contempt for the person in charge right now. No matter how many mind-numblingly stupid things he says though, it's clear to me that really smart people on both the public health side and the economics side are driving the discourse.

Trading other people's lives for the liberty and pursuit of happiness has obvious precedent in the US doesn't it? Didn't the draft send tens of millions of young people into harm's way, with hundreds of thousands dying and many, many more suffering life-long repercussions as a result? All to protect the opportunities for the majority of the population to enjoy liberty and pursue happiness.

People are protesting their businesses being shut down, or being unable to plant seeds to grow food on their own property (see: Michigan). If you think they are protesting some nebulous concept of "lockdown" you're being willfully ignorant. "It's the economy, stupid." And boy it there a lot of stupid on this forum.

No one is being prohibited from planting seeds on their own property in Michigan. We and many others have already started seedlings, and seeds are available for purchase from local hardware stores, some grocers, and via mail order. Probably also via curbside at Home Depot, as that's how we purchased some of our starter supplies. Guess what, we can also cut our own grass. Stop listening to Fox News.

Besides, anyone who lives here knows that no new plants go in the ground before Mother's Day because it will probably freeze and be killed.

The funny thing is . . . most of the protesters in clips on the news appear to be protesting in an unsafe manner, likely to spread the virus.  And spreading the virus will end up keeping businesses shut down for longer.  So they seem to be protesting in order to increase lockdown times and worsen the economy.  Seems kinda goofy.

[OtherJen]

The government might not do it but it's sensible public policy to value lives unequally.

Depends upon what the public thinks IMO. And the US Government value of a statistical life attempts to quantify how much the public values life. If there's enough push back, then that says something about the value of life, and the government should rethink the lockdown and the calculation.

Even so, that's a little problematic from a civil liberties perspective. I've seen a lot of argument on the anti-lockdown side regarding civil liberties. But life is also a civil liberty, and in the Declaration of Independence, one of my country's most cited documents, it's actually listed before liberty, and the pursuit of happiness.

People trade their own life for liberty and the pursuit of happiness all the time when they take up smoking or skydiving. But since this is a public health crisis, we're talking about trading others lives for our liberty and pursuit of happiness. Or the other way around.

We're talking bout a large number of lives and an even larger number of persons having their pursuit of happiness impacted. It's a tricky situation and we gotta be careful and get it right. Having studied this for months, I think the US response is decently close to "getting it right". And this is coming from someone with absolute contempt for the person in charge right now. No matter how many mind-numblingly stupid things he says though, it's clear to me that really smart people on both the public health side and the economics side are driving the discourse.

Trading other people's lives for the liberty and pursuit of happiness has obvious precedent in the US doesn't it? Didn't the draft send tens of millions of young people into harm's way, with hundreds of thousands dying and many, many more suffering life-long repercussions as a result? All to protect the opportunities for the majority of the population to enjoy liberty and pursue happiness.

People are protesting their businesses being shut down, or being unable to plant seeds to grow food on their own property (see: Michigan). If you think they are protesting some nebulous concept of "lockdown" you're being willfully ignorant. "It's the economy, stupid." And boy it there a lot of stupid on this forum.

No one is being prohibited from planting seeds on their own property in Michigan. We and many others have already started seedlings, and seeds are available for purchase from local hardware stores, some grocers, and via mail order. Probably also via curbside at Home Depot, as that's how we purchased some of our starter supplies. Guess what, we can also cut our own grass. Stop listening to Fox News.

Besides, anyone who lives here knows that no new plants go in the ground before Mother's Day because it will probably freeze and be killed.

The funny thing is . . . most of the protesters in clips on the news appear to be protesting in an unsafe manner, likely to spread the virus.  And spreading the virus will end up keeping businesses shut down for longer.  So they seem to be protesting in order to increase lockdown times and worsen the economy.  Seems kinda goofy.

Yep. Case numbers are still rising in smaller cities and more rural areas of Michigan. The protesters weren't from Detroit.

[MudPuppy]

Texas will let the stay at home order expire at the end of the month and phase in a reopening.

Not a bad state to start with as infections and deaths per capita are rather low. Hopefully we get some good data here.

My state (some densely populated counties excluded) is also opening, starting with reduced capacity and restaurants and retail. They are hoping we'll be entertained enough we won't realize they're trying to wriggle out of unemployment payments, I guess. We are certainly in a better position than several other states based on our resources and our current testing capacities, but I still feel we're a week or two too soon. Apparently several local restaurants agree and have declined to stop doing to-go only for now.

[mathlete]

https://twitter.com/NateSilver538/status/1254130268732100609

I like Nate's take here. Scientific communication can always stand to be improved. Nate knows this first hand because in 2016, he said that one candidate had a 25-30% chance of winning the presidency and then people got mad at him when that candidate won. I guess they interpreted 25-30% to mean 0%.

Nate privately (and a little publicly) fumed about how stupid people are, but at the end of the day, he went back to the drawing board to find different ways to communicate probability. His 2018 election model incorporated fractions and full written statements about probability and people seemed to respond better.

Of course, none of this cosigns any garbage I've seen about WHO and CDC scientists uselessly collecting paychecks.

[Jon Bon]

Should be change the title of this from "Flatten the Curve" to "Controlled Heard Immunity"

Don't we want to slowly infect our healthy low risk folks while protecting our older high risk folks? We were able to protect our hospitals, they were not overwhelmed. So not is it not a focus on keeping the level of infections at a manageable level. I feel like that was basically the plan from day 1. Opening up slowly as to prevent a spike but allow a manageable number of new cases.

No way we can eliminate the disease the US, so its time to focus on limiting health and economic damage. We dont have any easy choices left, just between bad and worse.

[mathlete]

On protests; both of these can be true.

1.) The protests are politically motivated AstroTurf affairs
2.) People are frustrated and want to get back to work since economic relief measures will always fall at least somewhat short

[Jon Bon]

On protests; both of these can be true.

1.) The protests are politically motivated AstroTurf affairs
2.) People are frustrated and want to get back to work since economic relief measures will always fall at least somewhat short
3)People are bored
4)People don't like their rights being taken away
5) People are crazy

I added a few!

But yeah I mostly agree with you.

[somebody8198]

Once you start to see "structural racism" in a study, you can safely close it and throw it in the garbage.

Meanwhile, back on planet Earth, the data says that:
- a very large portion of deaths have an underlying condition, like lung disease, cancer, or immune disease. No, nobody is saying they "deserve" to die because of their comorbidity; it is just a fact in the world which must inform our response to the disease.
- 73% of NYC deaths were age 65 and older; only 3 people under 18 were confirmed deaths and they had an existing condition. That strongly suggests the current recommendation to keep nursing homes and assisted living facilities and hospitals under lock and key to protect those most likely to become seriously ill.
- NYC hospitalizations for Covid are down to only 60 individuals as of April 24. That is likely much lower now as of this writing. No, the hospital system isn't overwhelmed and never became overwhelmed. It's incredible that we could pull tens of thousands more beds and ventilators out of our ass in a few weeks, but we don't need them.*

Antibody studies are also suggesting a large portion of the population has already been exposed, in which case we'll have to revise the infection rates upwards – which drive the fatality rate lower:
- About 25% of those sampled in NYC showed the presence of antibodies.
- A Stanford study suggests asymptomatic carriers were "between 48,000 and 81,000 people infected in Santa Clara County by early April, 50- 85-fold more than the number of confirmed cases."

Sources:
- https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-daily-data-summary-deaths-04192020-1.pdf
- https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1.full.pdf
- https://www1.nyc.gov/site/doh/covid/covid-19-data.page


* In fact, where I live (not NYC), hospitals are now at less than half of their normal capacity, and entire sections of hospitals are being closed because they were reserved for Covid patients who never showed up. That means a lot of people are being denied medical procedures they need, such as surgeries.

[mathlete]

On protests; both of these can be true.

1.) The protests are politically motivated AstroTurf affairs
2.) People are frustrated and want to get back to work since economic relief measures will always fall at least somewhat short
3)People are bored
4)People don't like their rights being taken away
5) People are crazy

For sure. I'm certainly going a little crazy myself.
I added a few!

But yeah I mostly agree with you.

[Kris]

On protests; both of these can be true.

1.) The protests are politically motivated AstroTurf affairs
2.) People are frustrated and want to get back to work since economic relief measures will always fall at least somewhat short
3)People are bored
4)People don't like their rights being taken away
5) People are crazy
6) People are being misinformed by the slanted sources they watch and listen to, so they are being encouraged to underestimate the risks and deride any source that tells them otherwise

I added a few!

But yeah I mostly agree with you.

There's another one for the list.

[Jon Bon]

On protests; both of these can be true.

1.) The protests are politically motivated AstroTurf affairs
2.) People are frustrated and want to get back to work since economic relief measures will always fall at least somewhat short
3)People are bored
4)People don't like their rights being taken away
5) People are crazy
6) People are being misinformed by the slanted sources they watch and listen to, so they are being encouraged to underestimate the risks and deride any source that tells them otherwise

I added a few!

But yeah I mostly agree with you.

There's another one for the list.

That can be true for all of us.

So in response, ill post some the most accurate numbers we have so far.

[Kris]

On protests; both of these can be true.

1.) The protests are politically motivated AstroTurf affairs
2.) People are frustrated and want to get back to work since economic relief measures will always fall at least somewhat short
3)People are bored
4)People don't like their rights being taken away
5) People are crazy
6) People are being misinformed by the slanted sources they watch and listen to, so they are being encouraged to underestimate the risks and deride any source that tells them otherwise

I added a few!

But yeah I mostly agree with you.

There's another one for the list.

That can be true for all of us.

So in response, ill post some the most accurate numbers we have so far.

Those are some numbers, all right.

[mathlete]

Systemic racism is absolutely a thing, and I'm always willing to go to bat for that. Since it's beyond the scope of this thread though, I'll direct anyone who wants to argue the counterpoint to this post here: https://forum.mrmoneymustache.com/welcome-to-the-forum/why-this-fire-concept-as-it-exists-is-so-difficult-for-minorities-to-achieve/msg2010910/#msg2010910

[GuitarStv]

Once you start to see "structural racism" in a study, you can safely close it and throw it in the garbage.

Perhaps people would be more willing to accept your posts as better informed if you didn't allow your deep seated pre-judgments and prejudices to prevent you from examining data.

[Davnasty]

Should be change the title of this from "Flatten the Curve" to "Controlled Heard Immunity"

Don't we want to slowly infect our healthy low risk folks while protecting our older high risk folks? We were able to protect our hospitals, they were not overwhelmed. So not is it not a focus on keeping the level of infections at a manageable level. I feel like that was basically the plan from day 1. Opening up slowly as to prevent a spike but allow a manageable number of new cases.

No way we can eliminate the disease the US, so its time to focus on limiting health and economic damage. We dont have any easy choices left, just between bad and worse.

Sort of, but I think the "manageable cases" goal is a lower number than what you're thinking of. There is something between eradication and herd immunity through infection* but it's a long term plan and it requires getting infection numbers down very low (the lower the better) before the next steps are implemented. Once infection numbers are low enough and testing/tracing is high enough, it should be possible to keep the growth flat or trending down with much less severe economic restrictions. You don't need full eradication to avoid exponential growth, you need R0 of 1 or less. In the meantime the world will be working on treatments, vaccines, and learning more about the virus every day.

I think the reality is we don't actually know how this thing will end. Will there be a vaccine? Will there be treatment that makes it less deadly? No one can answer these questions with certainty, but the more time we can buy, the better our chances of finding a solution will be. Right now, the time we're buying is coming at a high economic cost, but with each step we take forward in re-opening, that cost will be reduced. At some point behavioral modifications alone may be enough to keep R0 under 1 with almost no economic harm. Things like wearing masks, keeping our distance, staying home when sick, washing hands more, and lots of other small changes can make a big difference without shutting down businesses. At that point the cost of buying time will be a small fraction of what we're paying now.

Unfortunately the specifics of a plan like this are boring, the results are slow, and the outcome is uncertain. News media likes to talk about exciting, fast, and certainty (and of course fear, from both an economic and human health angle). The intelligent approach doesn't get much attention.

Then there's the question of whether the government will actually go this route and manage the strategy with competency and whether the citizens will go along with it. Some countries will be more successful than others. My expectations for the US aren't great.

*Also keep in mind that herd immunity through infection is not a given. We can say with some confidence that our bodies will create antibodies and provide immunity because that's the case with most viruses but we're not certain to what extent they will protect us or how long they will last. What if immunity only lasts for 6 months? We wouldn't know until next fall and at that point most early cases would be losing immunity and the virus would be endemic. What then? And of course there are many more possible scenarios that need to be taken into consideration.

[mm1970]

Yeah, fuck all the obese people and people with diabetes, etc. Especially the poor ones living in food deserts, and without decent medical care, and no access to a gym, or money to afford a membership, and no one who knows about fitness or cooking to teach them better habits. Fuck ‘em all. I got mine.

I am seriously, honestly, terrified.  My stepfather is immuno-compromised (going through regular cancer treatment) and an obese diabetic.   He's been dealing with diabetes for decades, but handling that while living alone, unable to exercise, after 18 months of cancer treatment (and regular trips to the hospital for treatment) is fucking hard.  He's not lazy, stupid, or unworthy of medical care.  (In fact he has great insurance from his pension and his treatment over the last few years has probably been at least half a million bucks.)

"Knowingly living a bad lifestyle" - that guy can just fuck right off.  People get sick and have co-morbidities that have nothing to do with being unworthy, lazy, or terrible people.  Read a few books dude.

I took the comment as sarcasm

Oh I know @Kris was being sarcastic.  My anger is directed at the same person that Kris was responding to.

[mm1970]

On protests; both of these can be true.

1.) The protests are politically motivated AstroTurf affairs
2.) People are frustrated and want to get back to work since economic relief measures will always fall at least somewhat short
3)People are bored
4)People don't like their rights being taken away
5) People are crazy
6) People are being misinformed by the slanted sources they watch and listen to, so they are being encouraged to underestimate the risks and deride any source that tells them otherwise

I added a few!

But yeah I mostly agree with you.

There's another one for the list.

That can be true for all of us.

So in response, ill post some the most accurate numbers we have so far.

Those numbers do NOT give me the warm and fuzzies, being in the 45-54 age group and heading towards the next, with two small children.

It seems fine and all until you look around and realize that a 10-15% death rate in the over 60 group means you can look at your coworkers and imagine 2 of them dead.  Not to mention family members.

[Jon Bon]

Should be change the title of this from "Flatten the Curve" to "Controlled Heard Immunity"

Don't we want to slowly infect our healthy low risk folks while protecting our older high risk folks? We were able to protect our hospitals, they were not overwhelmed. So not is it not a focus on keeping the level of infections at a manageable level. I feel like that was basically the plan from day 1. Opening up slowly as to prevent a spike but allow a manageable number of new cases.

No way we can eliminate the disease the US, so its time to focus on limiting health and economic damage. We dont have any easy choices left, just between bad and worse.

Sort of, but I think the "manageable cases" goal is a lower number than what you're thinking of. There is something between eradication and herd immunity through infection* but it's a long term plan and it requires getting infection numbers down very low (the lower the better) before the next steps are implemented. Once infection numbers are low enough and testing/tracing is high enough, it should be possible to keep the growth flat or trending down with much less severe economic restrictions. You don't need full eradication to avoid exponential growth, you need R0 of 1 or less. In the meantime the world will be working on treatments, vaccines, and learning more about the virus every day.

I think the reality is we don't actually know how this thing will end. Will there be a vaccine? Will there be treatment that makes it less deadly? No one can answer these questions with certainty, but the more time we can buy, the better our chances of finding a solution will be. Right now, the time we're buying is coming at a high economic cost, but with each step we take forward in re-opening, that cost will be reduced. At some point behavioral modifications alone may be enough to keep R0 under 1 with almost no economic harm. Things like wearing masks, keeping our distance, staying home when sick, washing hands more, and lots of other small changes can make a big difference without shutting down businesses. At that point the cost of buying time will be a small fraction of what we're paying now.

Unfortunately the specifics of a plan like this are boring, the results are slow, and the outcome is uncertain. News media likes to talk about exciting, fast, and certainty (and of course fear, from both an economic and human health angle). The intelligent approach doesn't get much attention.

Then there's the question of whether the government will actually go this route and manage the strategy with competency and whether the citizens will go along with it. Some countries will be more successful than others. My expectations for the US aren't great.

*Also keep in mind that herd immunity through infection is not a given. We can say with some confidence that our bodies will create antibodies and provide immunity because that's the case with most viruses but we're not certain to what extent they will protect us or how long they will last. What if immunity only lasts for 6 months? We wouldn't know until next fall and at that point most early cases would be losing immunity and the virus would be endemic. What then? And of course there are many more possible scenarios that need to be taken into consideration.

Well put.

Thanks for thoughtfully answering my question.

[boy_bye]

Once you start to see "structural racism" in a study, you can safely close it and throw it in the garbage.

Once you see someone deny the existence and impact of structural racism, you can safely ignore them; their opinions are garbage.

[Kris]

Once you start to see "structural racism" in a study, you can safely close it and throw it in the garbage.

Once you see someone deny the existence and impact of structural racism, you can safely ignore them; their opinions are garbage.

+1.

[ROF Expat]

The government might not do it but it's sensible public policy to value lives unequally.

Depends upon what the public thinks IMO. And the US Government value of a statistical life attempts to quantify how much the public values life. If there's enough push back, then that says something about the value of life, and the government should rethink the lockdown and the calculation.

Even so, that's a little problematic from a civil liberties perspective. I've seen a lot of argument on the anti-lockdown side regarding civil liberties. But life is also a civil liberty, and in the Declaration of Independence, one of my country's most cited documents, it's actually listed before liberty, and the pursuit of happiness.

People trade their own life for liberty and the pursuit of happiness all the time when they take up smoking or skydiving. But since this is a public health crisis, we're talking about trading others lives for our liberty and pursuit of happiness. Or the other way around.

We're talking bout a large number of lives and an even larger number of persons having their pursuit of happiness impacted. It's a tricky situation and we gotta be careful and get it right. Having studied this for months, I think the US response is decently close to "getting it right". And this is coming from someone with absolute contempt for the person in charge right now. No matter how many mind-numblingly stupid things he says though, it's clear to me that really smart people on both the public health side and the economics side are driving the discourse.

Trading other people's lives for the liberty and pursuit of happiness has obvious precedent in the US doesn't it? Didn't the draft send tens of millions of young people into harm's way, with hundreds of thousands dying and many, many more suffering life-long repercussions as a result? All to protect the opportunities for the majority of the population to enjoy liberty and pursue happiness.

People are protesting their businesses being shut down, or being unable to plant seeds to grow food on their own property (see: Michigan). If you think they are protesting some nebulous concept of "lockdown" you're being willfully ignorant. "It's the economy, stupid." And boy it there a lot of stupid on this forum.

Once you see someone calling those who disagree with them "stupid" you can safely ignore them;  their opinions are garbage.

[fattest_foot]

Should be change the title of this from "Flatten the Curve" to "Controlled Heard Immunity"

Don't we want to slowly infect our healthy low risk folks while protecting our older high risk folks? We were able to protect our hospitals, they were not overwhelmed. So not is it not a focus on keeping the level of infections at a manageable level. I feel like that was basically the plan from day 1. Opening up slowly as to prevent a spike but allow a manageable number of new cases.

No way we can eliminate the disease the US, so its time to focus on limiting health and economic damage. We dont have any easy choices left, just between bad and worse.

Something no one seems to be addressing is our healthcare system. The goal was to not overwhelm it, but what if we're on the verge of a healthcare catastrophe because they have to close? News came out yesterday that Mayo Clinic is furloughing 30,000 workers.

It's time to face it that we had a severe overreaction, or maybe wrong reaction, to this virus. I don't fault the initial reaction because of the unknowns, but now that we have more information, it seems like we should course correct. Instead we're just doubling down on bad decisions.

[Jon Bon]

Applying a little math to the CDC numbers.

I assumed a 2% mortality rate, which I think is a reasonable assumption. I have seen much higher and much lower so I grabbed something in the middle.

Then I backed into total cases by saying 27k deaths/.02 giving me the 1.38 million cases.  Then I applied those 1.38 million cases proportionally across the population groups.  So now I have assumed cases by age group, and actual deaths.  So now its a function of deaths/assumed cases give you a mortality rate.

This is a model, like all models it is subject to assumptions. But it does show that covid, like most respiratory diseases is more deadly the older you get.

I am happy to run it at different IFR if folks are curious. Also feel free to check my math if I fat fingered anything.