How long can we wait while flattening the curve?

[Abe]

So someone will have to provide data showing an increase in suicides if they’re going to use that as an argument against the lockdown

"Dear everyone, please save me the trouble of spending five minutes with google, because I thought maybe that when a person was sacked and broke they'd be happy."
Okay.

"After the 2008 economic crisis, rates of suicide increased in the European and American countries studied, particularly in men and in countries with higher levels of job loss." - source 1

"prior to the onset of recession in 2007, suicide rates had been falling in Europe. Subsequently, this downward trend reversed, rising by 6.5% by 2009 and remaining elevated through 2011. This increase corresponds to an additional 7950 suicides above what would be expected on past trends between 2007 and 2010" - source 2

"Being unemployed was associated with a twofold to threefold increased relative risk of death by suicide, compared with being employed." - source 3

Oh and see figure 1 here - source 4

So your first source showed an excess suicide of ~5000 across all 54 countries studied. That’s an incredibly small number and you should know that the statistical significance in that finding is confounded by lack of multiple comparisons.
Also, “ Spearman’s correlation coefficients between suicide rate ratios in 2009 and percentage point changes in unemployment rates between 2007 and 2009 were 0.25 (P=0.075) in men and 0.10 (P=0.49) in women. In men, the correlation coefficient was 0.48 (P=0.016) in men countries with relatively low unemployment levels (<6.2%) before the crisis and 0.31 (P=0.13) in countries with high unemployment levels (≥6.2%) before the crisis.“ no statistical correlation there when comparing actual unemployment to actual suicides, except in men in select countries with low unemployment pre-recession.  From their discussion: “ Further, our analysis of suicides in the USA suggested that unemployment only explained a small proportion of the variance in suicide rates. Consequently, there is still a large residual not explained by economic shocks.”

Study two was poorly done, showing correlation but not even attempting to show causation, and providing no statistics for their main result. They nevertheless again noted “ Despite large recessions, some countries experienced no change in suicides, whereas in others suicides rose in step with worsening economies.” And they discussed it may be preventable in subsequent paragraphs.

Source 3 was a study from 1991 in New Zealand and found “ In a multivariable model the association of socioeconomic factors with suicide reduced to the null. However, marital status and labour force status remained strong predictors of suicide death. Unemployment was also strongly associated with suicide death among 18–24 year old men. Sensitivity analyses suggested that confounding by mental illness might explain about half, but not all, of the association between unemployment and suicide.”
That’s a very specific portion of the population, unrelated to a recession and also their note about mental illness being a major factor is quite relevant. Again not irreversible.

From the abstract from source 4: “In addition, while the impact has generally become stronger over recent decades, it fell during the Great Recession although remained significant.” Wouldn’t it increase if tied directly to the recession? I can't comment further as I don't have access to this article.

The CDC provides this figure: https://www.cdc.gov/nchs/images/databriefs/351-400/db362-fig1.png
They note that suicide rates started increasing in 2006, before the recession started, in men (started increasing by 0.2-0.5 per 100,000 each year since then). For the total population it started in 1996 with no significant acceleration afterwards (increase of 0.2-0.4 per 100,000 each year), and for women 1999 with no significant acceleration (increase of -0.1 to 0.3 per 100,000 per year).

For men, suicide rates in 2007 for men 18.5 per 100,000 and in 2018 was 22.8 per 100,000.
For women, 4.0 per 100,000 and 6.2 per 100,000
Total 10.5 per 100,000 in 1999 and 14.2 per 100,000 in 2018.
These trends are thus seemingly related to pre-existing economic factors rather than the recession itself.

You are thus technically correct that there is weak evidence to suggest a small increase in deaths. But overall trends show no major difference. Also if we’re being utilitarian here, an excess 5k deaths would be 2 days worth from this epidemic. Please explain how this bolsters the argument of re-opening the economy without proper infection containment measures in place (not sure if that's your argument, sorry, it's hard to keep track of everyone).

[Abe]

The good news is that though no one has plateaued yet (0 deaths per day), most states seem to have reached a stable rate of daily deaths (the shoulder before the plateau). I do think we're getting close to reopening in the states that have good testing in place!

[Kyle Schuant]

Also if we’re being utilitarian here, an excess 5k deaths would be 2 days worth from this epidemic.

The US is not the whole world, you know mate.

[Abe]

Also if we’re being utilitarian here, an excess 5k deaths would be 2 days worth from this epidemic.

The US is not the whole world, you know mate.

I totally agree and think that Australia probably needs a different plan than a total lockdown since you’ve gotten things under control. I’m not sure if your comment is about the 5k excess deaths from the recession (that is across 54 countries per article 1, table 1, not just the US) or the 2k per day deaths currently (that’s just in the US, if we include Europe it’s about 3.5k per day).

[obstinate]

Also if we’re being utilitarian here, an excess 5k deaths would be 2 days worth from this epidemic.

The US is not the whole world, you know mate.

Is the implication here that in some other countries the death rate from the virus would magically be lower than it is in the US under the same treatments? Yes, there are countries that have done a much better job of controlling the virus, but as I understand it the argument is move in the direction of handling things like the US did, and, by implication, allow the virus to get out of control and have roughly the same public health effects as it is having in the US.

[Bloop Bloop]

Also if we’re being utilitarian here, an excess 5k deaths would be 2 days worth from this epidemic.

The US is not the whole world, you know mate.

Is the implication here that in some other countries the death rate from the virus would magically be lower than it is in the US under the same treatments? Yes, there are countries that have done a much better job of controlling the virus, but as I understand it the argument is move in the direction of handling things like the US did, and, by implication, allow the virus to get out of control and have roughly the same public health effects as it is having in the US.

There are states in Australia that (now) have less rigorous lockdown laws than New York but they have nothing like New York's numbers, because 1) different population density, 2) different testing regime (my state of 5 million people did over 10,000 tests today, and can test anyone who wants it), and most importantly, 3) different side of the curve. Once you have the disease under control the rate of infection/death becomes very modest.

https://www.theage.com.au/politics/federal/restrictions-costing-the-country-4-billion-a-week-frydenberg-20200504-p54pp4.html

I'm glad we are finally moving onto the "easing" stage and the stage where the government starts talking about the economic damage. The restrictions are costing us $4 billion a week. It may well be that the first 7 weeks of lockdown were justified, but there's little justification for much more of it (and indeed, we're thawing as we speak) so that gives me comfort that people are remembering the economic cost and not just the health-related cost of the pandemic.

[mathlete]

This is somewhat a function of density, but New York is also the financial capital of the Western World. The tri-state area has two international airports, both of which serve more passengers a year than SYD. Tons of direct flights between NYC and Western Europe. While the English speaking world was figuring out how bad this would be, the tri-state area was receiving countless potential seeders from Western Europe.

Density surely makes things worse, but if you look at counties to the west of the Hudson in New Jersey, most of them have New York like deaths while being an order of magnitude less dense.

[GuitarStv]

Nevertheless - not having money or a job is a huge risk factor for alcoholism, mental health problems, overdose, and suicide.

I don't disagree with what you've written here . . . but studies would also suggest that having a job is also a huge risk factor for alchoholism (chrome-extension://ohfgljdgelakfkefopgklcohadegdpjf/https://pubs.niaaa.nih.gov/publications/arh23-4/284-291.pdf), and suicide (https://www.vice.com/en_ca/article/z3bx8y/workplace-suicide-increase-united-states).

[waltworks]

Interesting articles. It sounds like that's white collar workers, basically. Those folks haven't (generally) lost their jobs this time around.

I don't think losing your job as a dishwasher and being unable to support your family anymore is going to be better than having that job for your mental/physical health, though. Remember that almost 100% of the impact here is on the poor/working class, not the folks at MMM or Facebook.

-W

[Paper Chaser]

This is somewhat a function of density, but New York is also the financial capital of the Western World. The tri-state area has two international airports, both of which serve more passengers a year than SYD. Tons of direct flights between NYC and Western Europe. While the English speaking world was figuring out how bad this would be, the tri-state area was receiving countless potential seeders from Western Europe.

Density surely makes things worse, but if you look at counties to the west of the Hudson in New Jersey, most of them have New York like deaths while being an order of magnitude less dense.

I don't think there's a full grasp of scale in a lot of these comments from outside the US. The US has a ton of cases, and could've handled things differently for sure, but comparing to Aus, or NZ (or even Sweden on the other end of the spectrum) is tough simply because of the difference in size.

As a reminder, Australia would be just the third most populous state in the US. The number of people in the US that are receiving government unemployment benefits now outnumbers the entire population of Australia by something like 6 million people. The US has 149 different international airports and the longest unprotected border in the world. The volume of traffic into/out of the country (and specifically the NY/NJ/Boston area) is just so much different.

Logistically, it's a much tougher thing to shut that down than it is in far less populous island nations that have been able to more or less eradicate the virus within their borders after needing just a few hundred thousand tests vs many tens of millions in the US. And it should be easier for these smaller countries to test/trace moving forward as well for the same reasons.

[mathlete]

I don't think there's a full grasp of scale in a lot of these comments from outside the US. The US has a ton of cases, and could've handled things differently for sure, but comparing to Aus, or NZ (or even Sweden on the other end of the spectrum) is tough simply because of the difference in size.

As a reminder, Australia would be just the third most populous state in the US. The number of people in the US that are receiving government unemployment benefits now outnumbers the entire population of Australia by something like 6 million people. The US has 149 different international airports and the longest unprotected border in the world. The volume of traffic into/out of the country (and specifically the NY/NJ/Boston area) is just so much different.

Logistically, it's a much tougher thing to shut that down than it is in far less populous island nations that have been able to more or less eradicate the virus within their borders after needing just a few hundred thousand tests vs many tens of millions in the US. And it should be easier for these smaller countries to test/trace moving forward as well for the same reasons.

Yeah, none of this is to say I like how my country has reacted. I don't. Our president cut preparedness measures and when giving his reasoning, he said he didn't like the idea of paying people to sit around when they weren't needed. Dude doesn't understand what "preparedness means". He also talked about using cleaning solutions inside the human body. 40% of my countryman still approve. We're a bunch of dumbasses and all the Aussies on here should dunk on us for that.

But I truly believe that most of the country could be approaching tri-state level deaths if we didn't do what we did. The US has excellent scientists and most people in most states, and most governors and county officials, have heeded their warnings. So it's not all bad.

[Plina]

Nevertheless - not having money or a job is a huge risk factor for alcoholism, mental health problems, overdose, and suicide.

I don't disagree with what you've written here . . . but studies would also suggest that having a job is also a huge risk factor for alchoholism (chrome-extension://ohfgljdgelakfkefopgklcohadegdpjf/https://pubs.niaaa.nih.gov/publications/arh23-4/284-291.pdf), and suicide (https://www.vice.com/en_ca/article/z3bx8y/workplace-suicide-increase-united-states).

There is also a correlation between gun ownership and suicide. https://www.hsph.harvard.edu/means-matter/means-matter/risk/

[cerat0n1a]

This is somewhat a function of density, but New York is also the financial capital of the Western World. The tri-state area has two international airports, both of which serve more passengers a year than SYD. Tons of direct flights between NYC and Western Europe. While the English speaking world was figuring out how bad this would be, the tri-state area was receiving countless potential seeders from Western Europe.

Not sure it's entirely down to that; London has significantly bigger airport passenger numbers than New York and that's before you add on international train (& bus) arrival numbers. Also NY has a pretty sizeable proportion of domestic departures/arrivals, which is not the case for cities like Tokyo & Shanghai, which aren't too far behind on 2019 numbers.

Not sure that US posters appreciate the geography of Australia either. Sure, it's about the same size as the lower 48 states and mostly empty, but the vast majority of Australians live in big cities - both Sydney and Melbourne check in at around the 5 million people mark.

It's interesting to me how places which are big interchange hubs e.g Bangkok or Dubai with over 100 million international passengers per year seem to have mostly avoided major problems.

[Bloop Bloop]

Interesting articles. It sounds like that's white collar workers, basically. Those folks haven't (generally) lost their jobs this time around.

I don't think losing your job as a dishwasher and being unable to support your family anymore is going to be better than having that job for your mental/physical health, though. Remember that almost 100% of the impact here is on the poor/working class, not the folks at MMM or Facebook.

-W

I bet if white collar workers were losing their job like hospitality and some retail workers were, the mood on here about just enjoying the lockdown and spending time counting one's blessings, etc, would be very different.

[Abe]

Interesting articles. It sounds like that's white collar workers, basically. Those folks haven't (generally) lost their jobs this time around.

I don't think losing your job as a dishwasher and being unable to support your family anymore is going to be better than having that job for your mental/physical health, though. Remember that almost 100% of the impact here is on the poor/working class, not the folks at MMM or Facebook.

-W

I bet if white collar workers were losing their job like hospitality and some retail workers were, the mood on here about just enjoying the lockdown and spending time counting one's blessings, etc, would be very different.

My wife lost her job and I won’t have one after July. My new job is delayed indefinitely, one which I spent years working towards. I also realize the severity of this crisis and accept things I can’t control if it benefits others. Also my current job exposes me to far more covid patients than you’ll ever hopefully see.

[dang1]

https://www.sltrib.com/news/2020/05/04/utah-reopens-its-economy/
"And never have the benefits been this generous. On top of state payments that average about $430 a week, the federal government is providing $600 more. That’s the equivalent of being paid more than $25 per hour."


https://www.sandiegouniontribune.com/business/economy/story/2020-05-03/some-san-diegans-can-earn-more-on-unemployment-why-go-back-to-work
"gets $250 more a week than if he was actually working."

[waltworks]

LOL, if you can actually *get* the unemployment benefits. My wife (we're in UT) tried, and the system is set up very carefully to make it super hard to actually get anything. As I understand it they are trying to fix that, but there are a ton of people out of work for the last 6 weeks who haven't seen a dime.

-W

[Bloop Bloop]

Interesting articles. It sounds like that's white collar workers, basically. Those folks haven't (generally) lost their jobs this time around.

I don't think losing your job as a dishwasher and being unable to support your family anymore is going to be better than having that job for your mental/physical health, though. Remember that almost 100% of the impact here is on the poor/working class, not the folks at MMM or Facebook.

-W

I bet if white collar workers were losing their job like hospitality and some retail workers were, the mood on here about just enjoying the lockdown and spending time counting one's blessings, etc, would be very different.

My wife lost her job and I won’t have one after July. My new job is delayed indefinitely, one which I spent years working towards. I also realize the severity of this crisis and accept things I can’t control if it benefits others. Also my current job exposes me to far more covid patients than you’ll ever hopefully see.

The question is whether it benefits enough people to outweigh the people it's harming. Is saving the life of, for example, one 80-year old (and having 10 other patients in the ICU) worth 100 permanent lost jobs (and all the socio-economic damage that causes)? I'm not suggesting that those are the figures,  but the point is that at some point the balance swings in the other direction.

I think our Australian Prime Minister has the right focus. This is what he said today:

Thousands of Australian lives have been saved, when you look the experience of how Covid-19 has affected so many countries around the world, but we now need to get 1 million Australians back to work.

That is the curve we need to address.

We have had ... quite an amount of success as a national cabinet, federal government working together closely with state and territory governments to make sure we have been able to manage and contain the outbreak of the virus here in Australia.

In those decisions that we have taken have been incredibly important, and no doubt had we not taken them, not only with the health impact have been disastrous, but, the economic cost would have been even greater.

Then what we are now currently experiencing, and as the treasurer has gone into some detail today explaining, but it is also true that has come at a cost.

That cost will continue so long as we have Australians in a position where they are unable to open their businesses and go back to the offices, children unable to go back to school, and the many restrictions in place, that is why the national cabinet has been working very effectively today as we move towards the decisions we need to take on Friday, that will impact on these restrictions in weeks and months that are ahead.

Meanwhile our Victorian premier seems to only see one side of the ledger. He's forgetting about a lot of things, including the fact that our school students are still "learning from home" (which is completely ineffective in the current environment since it's not like parents/teachers have had much time to prepare or design a curriculum). Other states' children have gone back to school - which is better for both children and working parents - yet we still take an arbitrary approach.

But anyway, the mood is changing and I'm really glad that we'll soon be able to go back to something resembling normality and the economy will stop bleeding.

[Kyle Schuant]

Dalek Dan will keep us locked down for a while yet. If there are lots of cases, that's proof we need to be locked down - hey what about that stage 4 we were talking about a while back? That might do it! If there are few or no cases, that's proof what we're doing is working, so we should keep doing it.


There's a plan to reopen Crown Casino in late July - but not playgrounds, they say. Who came up with this plan? A taskforce headed by... Crown's former head of gaming. Hmm. Likewise, a plan to get AFL back in June but not... community social sport. Priorities.

[boy_bye]

There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

wow. in a forum FULL of shitty anti-fat sentiment, this is one of the shittiest things i've ever read.

Being obese is bad for your health. In other news, smoking and drinking don't help, either. In a world where we deny climate change, resource depletion and physiology, I realise that facts can hurt people's feelings, but there it is.

You can be obese and be a worthwhile person. You can be obese and sexy. You cannot be obese and healthy. Sorry.

are you a doctor?
have you seen my labs?
are you familiar with my medical history, or the medical histories of the millions of perfectly healthy people who happen to be classified as "obese"?

if not, then you're not able to say that with any authority at all. SORRY.

one more thing -- even "healthy" people dont stay that way forever, and i can say that with 100% authority.

[waltworks]

Kyle's right, sorry. Yeah, there are people who live long healthy lives while obese, just like lots of people eat fast food and chew tobacco every day and some of them live to 95.

And it doesn't make you a bad person. But it's straight up bad for you to be obese. Arguing otherwise is just silly. How many 85-100 year old skinny people do you know of? At least a few, right? How many obese ones? Zero.

-W

[Wolfpack Mustachian]

There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

wow. in a forum FULL of shitty anti-fat sentiment, this is one of the shittiest things i've ever read.

Being obese is bad for your health. In other news, smoking and drinking don't help, either. In a world where we deny climate change, resource depletion and physiology, I realise that facts can hurt people's feelings, but there it is.

You can be obese and be a worthwhile person. You can be obese and sexy. You cannot be obese and healthy. Sorry.

are you a doctor?
have you seen my labs?
are you familiar with my medical history, or the medical histories of the millions of perfectly healthy people who happen to be classified as "obese"?

if not, then you're not able to say that with any authority at all. SORRY.

one more thing -- even "healthy" people dont stay that way forever, and i can say that with 100% authority.

Genuine question. You, of course, don't have to respond, but I'm curious as to which point you're taking on this.

There's certainly a correlation between obesity and bad health things (at least if I'm wrong about that, please feel free to show me something that disproves it). Are you saying that there's no causation between obesity and bad health outcomes? Are you saying that even if there's some correlation that its individualized enough that you're more concerned with specific medical metrics like cholesterol and the like? I don't think anyone (or almost no one) is saying that there aren't obese people that are healthier than non obese people - at most they seem to be saying that if you're obese it's a correlation risk factor akin to smoking, excessive drinking, etc. I may be wrong in this assertion of what is being presented.

[GuitarStv]

Being obese isn't good, but being overweight doesn't mean you're going to die earlier.

https://www.nhs.uk/news/obesity/overweight-people-live-longer-study-claims/

[obstinate]

Being obese isn't good, but being overweight doesn't mean you're going to die earlier.

https://www.nhs.uk/news/obesity/overweight-people-live-longer-study-claims/

Correlation isn't causation, etc. etc. Also applies to studies showing the other direction. You need to be a little sophisticated than just looking at all cause mortality and BMI.

[T-Money$]

https://www.bbc.com/news/uk-politics-52553229

Lockdowns for everyone, but me...

[fattest_foot]

https://www.bbc.com/news/uk-politics-52553229

Lockdowns for everyone, but me...

I like that that article says he was "undermining" the lockdown. No, he was violating it to have an affair with a married woman.

Does anyone who's actually in a position to apply these lockdowns to us "plebes" actually believe in the severity of it? Because so far they all seem to be hypocrites. Rules for thee but not for me.

[Bloop Bloop]

He had been self-isolating and she had effectively been self-isolating. Big deal. Let people have sex if they like. The hysteria over these restrictions (don't visit your partner if you're not de facto! Don't drive on the roads! You'll clog them up for emergency service workers! [meanwhile only 10 covid patients remain in hospital statewide, and it's not like the hospital beds are all full with car accident victims]) is ridiculous.

Yeah, I understand that the professor dude was being hypocritical but that was because the authorities (other than in Sweden) have been forced to take such a ridiculously insular and paternalistic approach to scolding citizens like schoolchildren. "Don't play with each other!"

https://www.theguardian.com/society/2020/may/05/longer-lockdown-for-over-70s-would-allow-fewer-restrictions-for-rest-of-uk-scientists-suggest

But, I think the tide is turning. Australia is easing and even my loony state Victoria has today confirmed it will be easing as of next Monday. And this UK report hopefully encourages more of a moderate response which allows society to return to near-normal faster. It makes no sense to continue locking down 8/10 of the population to protect 2/10 of the population when you've already flattened the curve.

[Kyle Schuant]

have you seen my labs?

To be clear, I was using the generic "you." If it makes you feel better, substitute "a person" for "you" in my statements. I have no knowledge or interest in your personal circumstances or health. This may or may not come as news to readers: it's not about you, personally.

In general, a person who is obese will tend to be less healthy than if they were not. This remains true regardless of other concerns, like the person's character or sexiness or whatever.

Australia is easing and even my loony state Victoria has today confirmed it will be easing as of next Monday.

Where was this said? I've not seen it.

[Bloop Bloop]

“I have no doubt that there will be some easing, based on the conversations I’ve had … with my counterparts and the general trend we’ve had. Exactly what, and how much, and the timing, will be determined.”
(Brett Sutton - chief medical officer)

https://www.3aw.com.au/latest-covid-19-figures-chief-health-meatworks-cluster-grows-again-as-victoria-records-another-day-of-double-digits/

He hasn't specified the easing will come on 11 May, when the state government has said it will re-assess, but given that we know national easing will be announced on 8 May, it would be strange for any other timeframe to have been contemplated.

[Seadog]

Experts, such as they are, have become their own worst enemies.  It's not enough to be correct, the trick is in convincing others that you are correct.  A lot of experts seems to have forgotten that and from a cultural perspective have undermined their own credibility and those of other experts. The arrogance of so many experts is part of the problem as well. 

An example; globalism.  20-30 years ago, the professional political class and a whole lot of economists were singing it's praises.  And from my perspective     I'd have to agree: I'm probably a net beneficiary.  But that same globalism has come at a terrible price for a lot of the working class in the US.  They might have listened to the experts once, but they'll never listen to them on that again. 

Here' a more positive example of an expert who did it right: Dr. Fauci.  This guy is an expert in his field. But more importantly, he has a very persuasive way about him and has done a very good job of persuading Americans to treat COVID as a real threat. That's really the key here.  He could have had less impeccable credentials, but he successfully convinced many millions of of the danger.

That's an excellent example and took the words out of my mouth. Up until maybe 10-12 years ago, I wasn't exactly a climate denier, but a questioner. I honestly wanted to understand the issue from a boots on the ground level, since it was "so obvious". I have a degree and worked in hard sciences as an engineer, and everyone I was talking to about this came off like a frigging child and no one made a compelling case. "Think of C02 like a blanket". What? No. That's not good enough. Co2 is a gas, its not made of cotton, and I can't frigging see it. How about I think of CO2 as a gas. What about the sun? What about volcanoes? What about all those points all those deniers bring up? Why, specifically are they wrong? If you're explanation doesn't involves heavy use of terms like solar flux, watts, absorption lines, and lots of fun heat transfer protocols, then you clearly don't understand and are simply repeating what you've been told by someone you trust for whatever reason. No different than the people who don't understand it and are denying it from people they don't trust for whatever reason. After getting exhausted with this, even dealing with people way better educated than me, I eventually sat down and read huge swaths of the 4th IPCC report to try and get a handle on it. Frankly it was eye opening. Solid agreement and convincing evidence about the big key points, but uncertainty and questions about many of the finer ones. But it painted a bit of a different picture than what many people in the media who had skin in an alarmist game were saying.

'Seeker of truth" as another poster said is a good way of putting. While a hundreds pages of technical reading is a bit of a slog, it taught me some good lessons about listening to other people and the media and people who have something to gain financially for furthering a certain point of view. 

[Seadog]

Every life has value, I don't care whether the person is young, old, fat, thin, or whatever. I don't want anyone to die early. Because I don't want anyone to die early, I would like it if we did things which reduced the risk of that. This means that the restrictions we put in early in Australia were good, but now they are less good - because we're saving a few lives from the virus at the cost of hundreds of lives from suicide, overdose, cancer and heart disease.

Unfortunately, and this is present everywhere but one of the biggest biases out there is the effect from action vs the effect from inaction. I feel mustachians are uniquely away of it since it's tied to opportunity cost, and a sort of "pathway analysis" where you say if I go down this path, where does it get me, and if I go down this one where does it get me, then compare the outcomes.

End the lockdown and kill a few hundred people? Murderer! Those thousand or whatever suicides and ODs that never happened, so most people will simply look at it as 200 poor dead grannies. This is triply true for governments and companies who have public relations to worry about. "How do you *know* you saved a thousand people? You don't *know* that!"

This was also true for areas in Canada here that are particularly hit with hard drugs. A certain subset of very enthusiastic addicts would constantly OD, need ambulances, hospital stays, detox, whole nine yards - at a cost of tens of thousands of dollars a trip, dozens of times a year, only to do it again when the next cheque came. They tried a program where they gave these people free apartments, nurse visits every day, basically held their hand the whole way to stay sober and have a little bit of a normal life. The cost was significant for an apartment and lots of nurse time, but significantly less than all the hospital resources they were using up, not to mention the increase to the quality of their mental and physical health. It was a win all around. However, there was outrage from the public. "Why are we giving these worthless addicts free homes and nurses?!" Same story. It was a smaller cost by action, vs a much bigger cost by inaction. I think maybe because the active cost is certain, and the passive cost is uncertain. But what most people can't be bothered to look at is that like insurance, statistically with big groups their behavior as a whole will be quite predictive. It would likely be the case with the foregone suicides down there, but I still think it would be a very hard sell.

[Bloop Bloop]

Lots of things that have utilitarian benefits are hard sells. It would probably be a net cost saving if we reduced the cost of abortions from a few hundred dollars to free, and made it far easier for women to access them. But I don't see any politician advocating for it.

[Kyle Schuant]

“I have no doubt that there will be some easing, based on the conversations I’ve had … with my counterparts and the general trend we’ve had. Exactly what, and how much, and the timing, will be determined.”
(Brett Sutton - chief medical officer)

Yes, I've seen that now.


Interestingly, the context is:
- we were down to a few active cases a day, and a lot of recoveries
- active cases under 50
- April 2nd, a guy working at an abattoir tests positive for the virus
- three weeks go by, the health department does nothing
- turns out 50 people are infected
- a week later they close the plant
- likewise with a psych hospital, where one patient who asked about people in PPE was told by a staff member she was hallucinating
- and a couple of aged care homes, too
- now active cases have doubled to over 100


Confronted with his department's incompetence causing more infections than the public had managed to, Sutton suddenly gets all compromising on easing lockdowns. Hmmmm... :)

[Bloop Bloop]

One of my favourite restaurants, Longrain, just closed permanently. That's dozens of staff who won't have jobs. It's not like they can just transfer to the other thriving restaurant down the road, either. The whole industry is being demolished.

That's just a small taste of the human cost of locking down 100% of the population to save 20% instead of doing a Sweden and locking down the 20%.

[skp]

I am a nurse.  People might think they are a "healthy" obese patient and maybe they are.  Everyone is healthy until they get sick. Obese patients are difficult for nurses to take care of and good nursing care is important to getting them well and home.   Ambulating and turning patients is important for their recovery. We do bariatric ORs in our hospital and the doctor who does them is obsessed with ambulating them.  We get it but  I don't think she takes into consideration the difficulty and sometimes impossibility of doing it  when she orders us to ambulate a 350 pound patient who might have only been  in bed for one day but has knee issues and couldn't walk at all  before the surgery.  Even when there aren't preexisting mobility issues  and the patient is "only" obese- How about trying to turn that "healthy" 300 pound patient or trying to ambulate them after they've been in bed, heavily sedated, on a vent for 2 weeks.   They say it takes 3 days to recover from 1 day in bed.

[mathlete]

USA CENTRIC POST ALERT!!

COVID19 has been the leading daily killer in the US for about a month now, as measured by the 7 day moving average. Preliminary CDC monitoring of excess death, along with reporting form the Times and the Post seem to confirm that this is excess mortality and, and not clouded significantly by comorbidity.

Reported COVID deaths in Louisiana, and excess mortality in Ecuador don't give much support to the idea that warmer states could be spared vs. the Northeast. In my opinion, the difference in experience at the state level is more driven by how early the virus arrived (very early for NYC, which is a travel hub for visitors from Western Europe) and how early lockdown measures were put into place to slow community spread.

If we still want to go forward with opening up, as seems to be the plan, it should be for one of two reasons:

1.) We think we've got ways to keep transmission down. Masks. Acute awareness of distancing. Temperature scans. Mass testing. etc.
2.) We've decided that the mortality is acceptable on a QALY basis

But I think the idea that we should open up because this virus is "not that bad" is getting pretty close to totally defeated.

[dandarc]

@mathlete

1) the reason that should be behind any "open up" efforts.
2) the actual reason for these "open up" efforts.

Of course, we know how quickly things can escalate, so with premature opening, you run a serious risk of that mortality rate being well above the level that was deemed acceptable. And I'd think that a second attempt to close things down will be even more strongly resisted by those who are inclined to resist these things. So I'm back to pessimism on the whole situation here in the US.

[T-Money$]

The willful disregard for the staggering economic issues the COVID response has created is disgusting.

https://www.brookings.edu/blog/up-front/2020/05/06/the-covid-19-crisis-has-already-left-too-many-children-hungry-in-america/

This is the reason restrictions should be lifted, immediately.

Mortality of the elderly is acceptable. 

[MudPuppy]

Well I regretting opening the post of the ignored user.

[Cassie]

Sweden has a death rate 40% higher than us. What age is considered elderly? At 65 many people have 20 good years left.

[OtherJen]

Sweden has a death rate 40% higher than us. What age is considered elderly? At 65 many people have 20 good years left.

In the medical literature, age 65 years or older is considered elderly.

[nereo]

Mortality of the elderly is acceptable.

For some reason most of the elderly I have spoken with do not share your opinion.

[wanderlustNW]

Mortality of the elderly is acceptable.

For some reason most of the elderly I have spoken with do not share your opinion.

And the mortality of the elderly is not the only issue. There are long-term affects to children and and even middle aged people:
https://www.washingtonpost.com/health/2020/04/24/strokes-coronavirus-young-patients/

https://www.washingtonpost.com/health/2020/05/06/kawasaki-disease-coronavirus/

[boy_bye]

There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

wow. in a forum FULL of shitty anti-fat sentiment, this is one of the shittiest things i've ever read.

Being obese is bad for your health. In other news, smoking and drinking don't help, either. In a world where we deny climate change, resource depletion and physiology, I realise that facts can hurt people's feelings, but there it is.

You can be obese and be a worthwhile person. You can be obese and sexy. You cannot be obese and healthy. Sorry.

are you a doctor?
have you seen my labs?
are you familiar with my medical history, or the medical histories of the millions of perfectly healthy people who happen to be classified as "obese"?

if not, then you're not able to say that with any authority at all. SORRY.

one more thing -- even "healthy" people dont stay that way forever, and i can say that with 100% authority.

Genuine question. You, of course, don't have to respond, but I'm curious as to which point you're taking on this.

There's certainly a correlation between obesity and bad health things (at least if I'm wrong about that, please feel free to show me something that disproves it). Are you saying that there's no causation between obesity and bad health outcomes? Are you saying that even if there's some correlation that its individualized enough that you're more concerned with specific medical metrics like cholesterol and the like? I don't think anyone (or almost no one) is saying that there aren't obese people that are healthier than non obese people - at most they seem to be saying that if you're obese it's a correlation risk factor akin to smoking, excessive drinking, etc. I may be wrong in this assertion of what is being presented.

my point is that none of y'all know what you are talking about with this ob*sity shit. i am so tired of people thinking they understand complex stuff that (1) theyve never experienced and (2) is not understood well even by the folks who research it. anti-fat bias and bullshit like y'all are spouting is more of a risk factor for human health than adipose tissue. 

[MudPuppy]

+1 to what @madgeylou says. I’m a nurse, too.

[mathlete]

This probably goes without being said, but the US and the world has put through unprecedented economic relief measures. I’m not saying that it has been “enough”, but there is zero basis for the comment that economic issues are being willfully ignored.

[js82]

If we still want to go forward with opening up, as seems to be the plan, it should be for one of two reasons:

1.) We think we've got ways to keep transmission down. Masks. Acute awareness of distancing. Temperature scans. Mass testing. etc.
2.) We've decided that the mortality is acceptable on a QALY basis

But I think the idea that we should open up because this virus is "not that bad" is getting pretty close to totally defeated.

I'd add a #3(which might be a flavor of #2), which is that we(the USA) botched the initial containment badly enough that trying to get to a low infection level that enables contact tracing (a la Australia/SK) is unfeasible (both due to economic damage and public fatigue and resulting noncompliance with social distancing measures) to what it would take to bring infection rates down that far, such that our only viable option at this point may to be to go the Sweden route.

I don't like saying this - because it's an incredibly uncomfortable place to be, but I think the US is in a place where there's no good alternative, and the "ideal" approach is no longer viable due to how badly we've lost containment of the virus - and that the only realistic approach may be to move towards herd immunity while minimizing the damage in the process.

But I agree - the idea that this is "not that bad" is clearly false.  0.5-1% of 50% of the country is still a whole lot of potential deaths.  But it may be true that the alternative(i.e. the extent and duration of lockdown necessary to keep deaths down at the vaccine time horizon) is prohibitively costly, relative to our current state.

[JGS1980]

If we still want to go forward with opening up, as seems to be the plan, it should be for one of two reasons:

1.) We think we've got ways to keep transmission down. Masks. Acute awareness of distancing. Temperature scans. Mass testing. etc.
2.) We've decided that the mortality is acceptable on a QALY basis

But I think the idea that we should open up because this virus is "not that bad" is getting pretty close to totally defeated.

I'd add a #3(which might be a flavor of #2), which is that we(the USA) botched the initial containment badly enough that trying to get to a low infection level that enables contact tracing (a la Australia/SK) is unfeasible (both due to economic damage and public fatigue and resulting noncompliance with social distancing measures) to what it would take to bring infection rates down that far, such that our only viable option at this point may to be to go the Sweden route.

I don't like saying this - because it's an incredibly uncomfortable place to be, but I think the US is in a place where there's no good alternative, and the "ideal" approach is no longer viable due to how badly we've lost containment of the virus - and that the only realistic approach may be to move towards herd immunity while minimizing the damage in the process.

But I agree - the idea that this is "not that bad" is clearly false.  0.5-1% of 50% of the country is still a whole lot of potential deaths.  But it may be true that the alternative(i.e. the extent and duration of lockdown necessary to keep deaths down at the vaccine time horizon) is prohibitively costly, relative to our current state.

It'll be costly either way at this point. I agree THERE IS NO STOPPING COVID in the USA right now, although individual states' logistical response and effectiveness will vary.  This does not mean people will be out of their homes hunky dory any time soon. People will be extra cautious until a vaccine is available. This means the economy will be shot anyway. I don't know of any restaurants who will survive doing only 25% of regular business.  V shaped economic recovery seems increasingly unlikely because of this. The ones who are out and about will suffer more than those who can afford to stay in or who have the patience to do so.

Really awful circumstance for everyone.

[Wolfpack Mustachian]

There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

wow. in a forum FULL of shitty anti-fat sentiment, this is one of the shittiest things i've ever read.

Being obese is bad for your health. In other news, smoking and drinking don't help, either. In a world where we deny climate change, resource depletion and physiology, I realise that facts can hurt people's feelings, but there it is.

You can be obese and be a worthwhile person. You can be obese and sexy. You cannot be obese and healthy. Sorry.

are you a doctor?
have you seen my labs?
are you familiar with my medical history, or the medical histories of the millions of perfectly healthy people who happen to be classified as "obese"?

if not, then you're not able to say that with any authority at all. SORRY.

one more thing -- even "healthy" people dont stay that way forever, and i can say that with 100% authority.

Genuine question. You, of course, don't have to respond, but I'm curious as to which point you're taking on this.

There's certainly a correlation between obesity and bad health things (at least if I'm wrong about that, please feel free to show me something that disproves it). Are you saying that there's no causation between obesity and bad health outcomes? Are you saying that even if there's some correlation that its individualized enough that you're more concerned with specific medical metrics like cholesterol and the like? I don't think anyone (or almost no one) is saying that there aren't obese people that are healthier than non obese people - at most they seem to be saying that if you're obese it's a correlation risk factor akin to smoking, excessive drinking, etc. I may be wrong in this assertion of what is being presented.

my point is that none of y'all know what you are talking about with this ob*sity shit. i am so tired of people thinking they understand complex stuff that (1) theyve never experienced and (2) is not understood well even by the folks who research it. anti-fat bias and bullshit like y'all are spouting is more of a risk factor for human health than adipose tissue.

Ok...obviously you're ticked off about some of the comments, but I was asking a genuine question that you didn't really answer it except to accuse me of not knowing anything I'm talking about in regards to obesity. First, I have experienced it. I was in the morbidly obese category at one time in my life and am now still in the obese category given my weight and height. You comment that it's not well understood by those who research it. That's a pretty strong statement to make. Then you said that what I said was anti-fat bias and asserted that it's a greater risk factor for human health than obesity.

Again, feel free to not answer it. I just have noticed in several threads you posting comments about how no one else understands or everyone else is misrepresenting obesity, etc. I just figured, I'd take this opportunity to ask what you exactly mean. It's also not something I can quickly google, the response to a standard uninformed opinion, since in your text you comment that researchers don't seem to understand it.

Would you please like to elaborate as to any of my questions? Essentially, are you asserting there is no correlation between obesity and health problems? Or are you saying it's a correlation does not equal causation situation? Or are you saying that any health problems tied to obesity pale in comparison to the pyschological damage of fat shaming?

[Bloop Bloop]

Preliminary modelling from the Brain and Mind Centre predicts at least a 25% rise in suicides, with 30% of those being Australians aged 15 to 25.

“The impacts of unemployment will be greatest among the young,” centre co-director Ian Hickie said, according to AAP.

Professor Hickie said Australia could be facing between an extra 750 to 1,500 suicides per year on top of the more than 3,000 annually.

If we have an extra 1,000 suicides a year that would be a tragedy. Our death toll from the virus to date is <100 and includes a full "exponential" growth/flattening sequence from stage 0 to stage 3 lockdowns. So even if we eased too early and had to go through that growth/flattening sequence again (with another 100 deaths), it would still be minuscule compared to the economic damage.

NZ is loosening restrictions to stage 2 by next week - hopefully our coordinated response will be the same. Time to fix up the economy fellas so that we can stop haemorrhaging money and jobs.