Author Topic: How long can we wait while flattening the curve?  (Read 253739 times)

waltworks

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How long can we wait while flattening the curve?
« on: March 16, 2020, 12:48:37 PM »
Anecdotally, the town I live in (which is unusually dependent on tourism) is in total economic collapse. I'd say 75% of the service industry is out of work. Most businesses are closed. Construction is already grinding to a halt, as is school.

If this is the situation across the entire US, it's great depression level collapse we're talking about if it continues for more than a few weeks.

I'll put this question out there: are we risking a result that would be *worse* than uncontrolled spread of the coronavirus if we completely collapse our economy?

I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.

Maybe I'm crazy.

-W
« Last Edit: March 16, 2020, 12:50:28 PM by waltworks »

AnnaGrowsAMustache

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Re: How long can we wait while flattening the curve?
« Reply #1 on: March 16, 2020, 12:51:42 PM »
Anecdotally, the town I live in (which is unusually dependent on tourism) is in total economic collapse. I'd say 75% of the service industry is out of work. Most businesses are closed. Construction is already grinding to a halt, as is school.

If this is the situation across the entire US, it's great depression level collapse we're talking about if it continues for more than a few weeks.

I'll put this question out there: are we risking a result that would be *worse* than uncontrolled spread of the coronavirus if we completely collapse our economy?

I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.

Maybe I'm crazy.

-W

That's pretty much what the UK has decided to do. It makes sense only if you're confident you know everything you need to know about this virus. I don't see how they can be....

YttriumNitrate

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Re: How long can we wait while flattening the curve?
« Reply #2 on: March 16, 2020, 12:55:28 PM »
I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.Maybe I'm crazy. -W

Who said people die in a depression? Life expectancy rises in a depression:

https://www.sciencedaily.com/releases/2009/09/090928172530.htm

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #3 on: March 16, 2020, 12:57:59 PM »
We know a lot - not very dangerous (or at least, not moreso than the flu) for the young. A little more dangerous than the flu for the middle aged. Super dangerous for the elderly and immunocompromised.

My point is that I'm not sure our current approach is going to save any overall lives - and in fact it may cost *more* lives to shut down the economy. Old and infirm people can be isolated with minimal cost/disruption. It's not fun for them, and it's not free, but it wouldn't take much to deal with. Isolating *everyone* costs a LOT.

-W

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #4 on: March 16, 2020, 01:01:09 PM »
I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.Maybe I'm crazy. -W

Who said people die in a depression? Life expectancy rises in a depression:

https://www.sciencedaily.com/releases/2009/09/090928172530.htm

That is super interesting! The reasons they hypothesize about are sort of obvious, when you think about it:
-Working less is good for you (and less dangerous)
-Drinking and smoking less is good for you

Essentially, people use money to kill themselves...

Maybe I should root for a depression!

-W

JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #5 on: March 16, 2020, 01:04:26 PM »
UK is a grand experiment. There are 66.5 Milliion people in the UK.

Lets assume that 16.5 Million are in the high risk category and are able to perfectly self-quarantine for an "appropriate" amount of time.

That leaves 50 Million "low risk" folks that should be just fine, right?

Well, if we assume the low-low-low mortality rate of "only" 0.2% despite adequate medical care. That still leaves us with -------->>>>> 100,000 dead "low risk" healthy young people.

Do you find this number acceptable?

JGS
« Last Edit: March 16, 2020, 01:06:58 PM by JGS1980 »

Sanitary Engineer

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Re: How long can we wait while flattening the curve?
« Reply #6 on: March 16, 2020, 01:05:12 PM »
It seems like the link from @YttriumNitrate shows that economic downturns lead to fewer deaths.  This also supports the idea that an economic slowdown reduces the harm from poor air quality.  This isn't exhaustive data, but the link provides good support for the current approach reducing deaths and not just from flattening the curve of COVID-19.

I think of a depression as like forcing people into mustachianism and would likely have many long term positive impacts, beyond reducing deaths.

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #7 on: March 16, 2020, 01:08:13 PM »
Depends on what it would cost to save them.

I mean, if every person in the world had to give up all their money and possessions to save 1 life... nobody would go for that.

And if everyone in the world could give just a few cents to save millions, it would be terrible if people refused.

There is, in fact, a price on human life (in the US, it's around $8 million):
https://www.theglobalist.com/the-cost-of-a-human-life-statistically-speaking/

-W

JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #8 on: March 16, 2020, 01:16:28 PM »
Walt, How much per each of those 100,000 hypothetical lives?

$10,000 per life? $100,000? $10,000,000?

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #9 on: March 16, 2020, 01:19:20 PM »
Walt, How much per each of those 100,000 hypothetical lives?

$10,000 per life? $100,000? $10,000,000?

The numbers vary a lot, as a society, in terms of how we value life, but at the low end it's about $2 million (based on speed limits and known fatality rates). At the high end $9 million (EPA number).

So to save 100,000 lives, we should be willing to spend something between $200 billion and $1 trillion.

A 10% hit to US GDP (technical definition of a depression) would cost around $2 trillion.

-W

AnnaGrowsAMustache

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Re: How long can we wait while flattening the curve?
« Reply #10 on: March 16, 2020, 01:43:00 PM »
We know a lot - not very dangerous (or at least, not moreso than the flu) for the young. A little more dangerous than the flu for the middle aged. Super dangerous for the elderly and immunocompromised.

My point is that I'm not sure our current approach is going to save any overall lives - and in fact it may cost *more* lives to shut down the economy. Old and infirm people can be isolated with minimal cost/disruption. It's not fun for them, and it's not free, but it wouldn't take much to deal with. Isolating *everyone* costs a LOT.

-W

We don't know if you can get it more than once. We don't know the long term impact of having had it. It could easily cause invisible damage that comes out later, for example cardio issues or infertility. We don't know if you actually recover or if it recurs like malaria or something, or lies dormant for years like shingles. We don't know how it might be mutating right now into something more deadly. We dont even know how long people are infectious for after their symptoms stop.

Adam Zapple

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Re: How long can we wait while flattening the curve?
« Reply #11 on: March 16, 2020, 02:00:58 PM »
I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.Maybe I'm crazy. -W

Who said people die in a depression? Life expectancy rises in a depression:

https://www.sciencedaily.com/releases/2009/09/090928172530.htm

I learned something new today. 

Paper Chaser

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Re: How long can we wait while flattening the curve?
« Reply #12 on: March 16, 2020, 02:02:38 PM »
UK is a grand experiment. There are 66.5 Milliion people in the UK.

Lets assume that 16.5 Million are in the high risk category and are able to perfectly self-quarantine for an "appropriate" amount of time.

That leaves 50 Million "low risk" folks that should be just fine, right?

Well, if we assume the low-low-low mortality rate of "only" 0.2% despite adequate medical care. That still leaves us with -------->>>>> 100,000 dead "low risk" healthy young people.

Do you find this number acceptable?

JGS

This assumes that every young, healthy person would get the virus. Thus far, There's no place on Earth that's anywhere near even 10% of the total population getting it (including elderly and at-risk) let alone 10% of the young healthy demographic.
Expecting 100k young, healthy deaths seems wildly pessimistic to me.

To look at it another way, Hubei province has a population of about 58.5 million, which isn't far off of your UK population estimate of healthy people. They've had 67794 confirmed cases of COVID-19, with 3085 resulting in death over a 4 month period. That means that in the hardest hit place on the planet, 0.11% of the total population has confirmed cases, and 0.0052% of the total population died. That's including the elderly and predisposed.

Run those rates for the UK total population and you'd get 3454 deaths in all of the UK, with a large percentage of those coming from the weakest demographics.
« Last Edit: March 16, 2020, 02:37:42 PM by Paper Chaser »

BuildingFrugalHabits

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Re: How long can we wait while flattening the curve?
« Reply #13 on: March 16, 2020, 02:06:06 PM »
Walt.  I had the same thought today.  We seem to be lacking any sort of long term plan.  Keeping everyone away from each other seems like a good temporary measure but not a long term fix.  I don't think we can eradicate this thing with social distancing.  As soon as things go back to normal, activities resume and the virus starts to spread again.  What we need is to scale up the testing so that everyone who needs or wants a test can get one.   Whatever that looks like; a drug store test, a module for your smartphone, a swab you mail away, or drive through test centers all over the place.  We need to get the testing figured out and deployed quickly. 

Not sure how long it's reasonable to ask every person to simply behave like they have the disease.  We need to give people the information they need to live our lives and keep the people with the virus in a safe location with the care they need. 
« Last Edit: March 16, 2020, 02:14:30 PM by BuildingFrugalHabits »

nereo

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Re: How long can we wait while flattening the curve?
« Reply #14 on: March 16, 2020, 02:37:18 PM »
I think the strategy hasn't been articulated very well.

Simply put, if everyone self-quarantined for 14 days the virus would basically be halted in its tracks.  Obviously that can't/won't happen here but it gives you an idea of what these measures can do.  China basically passed its peak about a month after they publically admitted they had a problem and took drastic measures to combat the spread.  South Korea appears to have done it in just over 2 weeks.

Walt, the question you are asking is a good one.  The economic cost of doing nothing is likely >50% of the population infected near-simultaneously, with something along the lines of 10-15% having "severe" cases, a subset of those needing hospitalization and ~1% mortality IF we can find ventilators for them (we wouldn't be able to).  Side-stepping the mortalities and the cost-per-life for a moment, 10-15% of the population becoming severely sick would basically have a similar impact -- not only would those people not be able to work or go to school, but they would require friends/family to miss work to take care of them.  So there would STILL be major breakdowns in the supply chains as a good chunk of the workforce all called in sick.

So: do absolutely nothing and businesses get really choppy and potentially 1MM+ die here in the US (worst case projections from doing nothing), or shut down the entire country, grinding businesses to a complete halt, and hope for mortalities in the 5-figure range, but know that it still could be much worse

How do you measure those two costs against one another?  I honestly have no idea.  Propagation of errors would be enormous on both sides of the equation.


JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #15 on: March 16, 2020, 02:39:50 PM »
UK is a grand experiment. There are 66.5 Milliion people in the UK.

Lets assume that 16.5 Million are in the high risk category and are able to perfectly self-quarantine for an "appropriate" amount of time.

That leaves 50 Million "low risk" folks that should be just fine, right?

Well, if we assume the low-low-low mortality rate of "only" 0.2% despite adequate medical care. That still leaves us with -------->>>>> 100,000 dead "low risk" healthy young people.

Do you find this number acceptable?

JGS

This assumes that every young, healthy person would get the virus. Thus far, There's no place on Earth that's anywhere near even 10% of the total population getting it (including elderly and at-risk) let alone 10% of the young healthy demographic.

The longer the virus is around (and the more infectious it is), the closer to 100% of the population that will be effected. If it's "always around", we call that virus endemic. Think Chicken Pox (Varicella) before the vaccine was developed. We are VERY early in this process.

MilesTeg

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Re: How long can we wait while flattening the curve?
« Reply #16 on: March 16, 2020, 02:44:23 PM »
Walt.  I had the same thought today.  We seem to be lacking any sort of long term plan.  Keeping everyone away from each other seems like a good temporary measure but not a long term fix.  I don't think we can eradicate this thing with social distancing.  As soon as things go back to normal, activities resume and the virus starts to spread again.  What we need is to scale up the testing so that everyone who needs or wants a test can get one.   Whatever that looks like; a drug store test, a module for your smartphone, a swab you mail away, or drive through test centers all over the place.  We need to get the testing figured out and deployed quickly. 

Not sure how long it's reasonable to ask every person to simply behave like they have the disease.  We need to give people the information they need to live our lives and keep the people with the virus in a safe location with the care they need.

There is no attempt to _stop_ it. The idea is to _slow it down_. Almost certainly most people will eventually get this virus, we're past the point of containment. But, it's vastly preferable to have everyone get it over the course of a year or more than within a few weeks or months. This is what everyone is talking about when they repeat the phrase "flattening the curve".

This is why Italy is is shambles. The total numbers are still relatively low, but all those people got sick at the same time and overwhemled their health care system.

Paper Chaser

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Re: How long can we wait while flattening the curve?
« Reply #17 on: March 16, 2020, 04:39:38 PM »
UK is a grand experiment. There are 66.5 Milliion people in the UK.

Lets assume that 16.5 Million are in the high risk category and are able to perfectly self-quarantine for an "appropriate" amount of time.

That leaves 50 Million "low risk" folks that should be just fine, right?

Well, if we assume the low-low-low mortality rate of "only" 0.2% despite adequate medical care. That still leaves us with -------->>>>> 100,000 dead "low risk" healthy young people.

Do you find this number acceptable?

JGS

This assumes that every young, healthy person would get the virus. Thus far, There's no place on Earth that's anywhere near even 10% of the total population getting it (including elderly and at-risk) let alone 10% of the young healthy demographic.

The longer the virus is around (and the more infectious it is), the closer to 100% of the population that will be effected. If it's "always around", we call that virus endemic. Think Chicken Pox (Varicella) before the vaccine was developed. We are VERY early in this process.

Right. With a long enough timeline, and no progress toward a vaccine, or natural immunity development, or good luck, eventually everybody gets it. But I think it's important to state that if you're going to throw out exaggerated claims about 100k healthy young people dying from this in the UK. If 0.1% of young healthy Brits get this virus, and 0.1% of those perish from it (both higher rates than we've seen for the young, healthy demographic thus far) how long would it be before your claim becomes reality? Losing 100k healthy people in 12 months is a lot different than losing 100k healthy people over 30 years.

Duke03

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Re: How long can we wait while flattening the curve?
« Reply #18 on: March 16, 2020, 05:52:08 PM »
People will be homeless very shortly..... I'm sorry but this debacle will hurt the ones just barely getting by the most.  Restaurants, Theaters, and small business's cant pay their employees to stay at home.  They simply don't have the money.  Who will pay the rent?  This whole thing is portrayed by the media and everyone else.  Yes people will get sick and yes people will die.  As sad as this is it's been happening every single day since the beginning of man kind.  The Government is not going to pay your rent and the Government is not going to give you a paycheck. Yes they might send you a check for $1000 and then wash their hands of you.  The sad thing is the airline, cruise line, and travel industries are decimated.  Restaurants and small business's are up next. 

PDXTabs

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Re: How long can we wait while flattening the curve?
« Reply #19 on: March 16, 2020, 05:57:15 PM »
I'll put this question out there: are we risking a result that would be *worse* than uncontrolled spread of the coronavirus if we completely collapse our economy?

The more people you save the more supply and demand you preserve in the long run. The flatter the curve the more people will survive.

The Government is not going to pay your rent and the Government is not going to give you a paycheck.

There's this thing called unemployment insurance. There's another thing called SNAP. You may remember them from the great recession.
« Last Edit: March 16, 2020, 06:02:06 PM by PDXTabs »

JGS1980

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Re: How long can we wait while flattening the curve?
« Reply #20 on: March 16, 2020, 06:07:40 PM »
People will be homeless very shortly..... I'm sorry but this debacle will hurt the ones just barely getting by the most.  Restaurants, Theaters, and small business's cant pay their employees to stay at home.  They simply don't have the money.  Who will pay the rent?  This whole thing is portrayed by the media and everyone else.  Yes people will get sick and yes people will die.  As sad as this is it's been happening every single day since the beginning of man kind.  The Government is not going to pay your rent and the Government is not going to give you a paycheck. Yes they might send you a check for $1000 and then wash their hands of you.  The sad thing is the airline, cruise line, and travel industries are decimated.  Restaurants and small business's are up next.

So they will have to work for employers in more in demand fields like personal care, home delivery service, ventilator manufacturing, and online education until demand picks up again for their favored profession. They will have to hustle like they always have.  I think a 3-6 month moratorium on mortgage foreclosure would be a great idea to mitigate some short term effects of this crisis.

Telecaster

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Re: How long can we wait while flattening the curve?
« Reply #21 on: March 16, 2020, 06:20:38 PM »
Anecdotally, the town I live in (which is unusually dependent on tourism) is in total economic collapse. I'd say 75% of the service industry is out of work. Most businesses are closed. Construction is already grinding to a halt, as is school.

If this is the situation across the entire US, it's great depression level collapse we're talking about if it continues for more than a few weeks.

I'll put this question out there: are we risking a result that would be *worse* than uncontrolled spread of the coronavirus if we completely collapse our economy?

I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.

Maybe I'm crazy.

-W

The issue is that if too many people get infected at once we will overload our medical system and even more people will die needlessly due to lack of treatment.  Even though younger people are less affected, they are still affected and can certainly still die.  That's where Italy is right now.  They straight up don't have enough hospital beds for everyone who needs it and the medical staff is forced to decide who gets treatment and who dies.  If we can slow the spread just enough, we might be able to avoid that.  Possibly not, but it is about the only arrow left in the quiver. 

YummyRaisins

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Re: How long can we wait while flattening the curve?
« Reply #22 on: March 16, 2020, 06:32:06 PM »
Anecdotally, the town I live in (which is unusually dependent on tourism) is in total economic collapse. I'd say 75% of the service industry is out of work. Most businesses are closed. Construction is already grinding to a halt, as is school.

If this is the situation across the entire US, it's great depression level collapse we're talking about if it continues for more than a few weeks.

I'll put this question out there: are we risking a result that would be *worse* than uncontrolled spread of the coronavirus if we completely collapse our economy?

I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.

Maybe I'm crazy.

-W

The issue is that if too many people get infected at once we will overload our medical system and even more people will die needlessly due to lack of treatment.  Even though younger people are less affected, they are still affected and can certainly still die.  That's where Italy is right now.  They straight up don't have enough hospital beds for everyone who needs it and the medical staff is forced to decide who gets treatment and who dies.  If we can slow the spread just enough, we might be able to avoid that.  Possibly not, but it is about the only arrow left in the quiver.

I don't think Walt is disputing that flattening the curve will help avoid overloading our healthcare system and that doing so would save lives.

He's considering at what point the damage to the economy is so great that it would outweigh the value in saving those lives. Would it make more sense to take the hit and not crater the economy?

It's a hard problem for sure. Good luck convincing people at this point that it's worth the risk to go back to business as usual and keep the economy chugging, even if it makes sense financially.

Jack0Life

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Re: How long can we wait while flattening the curve?
« Reply #23 on: March 16, 2020, 06:55:11 PM »
Anecdotally, the town I live in (which is unusually dependent on tourism) is in total economic collapse. I'd say 75% of the service industry is out of work. Most businesses are closed. Construction is already grinding to a halt, as is school.

If this is the situation across the entire US, it's great depression level collapse we're talking about if it continues for more than a few weeks.

I'll put this question out there: are we risking a result that would be *worse* than uncontrolled spread of the coronavirus if we completely collapse our economy?

I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.

Maybe I'm crazy.

-W

This is interesting.
Others have mentioned that the government wants to flat out the curve so hospital doesn't get overwhelmed at the same time.
Another way to look at this is if we didn't do anything to subside the fears, businesses wouldn't be the same anyway.
Just the fears so being out and getting infected would cause reduce the activities of people and businesses would suffer anyhow. Many businesses wouldn't survive.
I'm guessing things won't be normal until we get a vaccine for this or by some miracle, this virus will die down during the summer like the flu.

PDXTabs

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Re: How long can we wait while flattening the curve?
« Reply #24 on: March 16, 2020, 07:07:39 PM »
This article talks about how the Wuhan fatality rate was 5.8% where as the fatality rate in the rest of China was 0.7%. That's the sort of difference that we are talking about by not having the hospitals overwhelmed.

Duke03

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Re: How long can we wait while flattening the curve?
« Reply #25 on: March 16, 2020, 07:24:24 PM »
I'll put this question out there: are we risking a result that would be *worse* than uncontrolled spread of the coronavirus if we completely collapse our economy?

The more people you save the more supply and demand you preserve in the long run. The flatter the curve the more people will survive.

The Government is not going to pay your rent and the Government is not going to give you a paycheck.

There's this thing called unemployment insurance. There's another thing called SNAP. You may remember them from the great recession.


We can go back and forth all day long.  Try paying rent and all your living expenses with zero savings and only getting $454 a week in unemployment.  The average cost of a one bedroom apt in my city is $950 and I live in a LCOL area....  SNAP is also a joke if you are a single male.  They would just assume you starve.  I think they might give you $40 a week, but will turn their nose up at you if you dare tell them you have a car payment.

PDXTabs

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Re: How long can we wait while flattening the curve?
« Reply #26 on: March 16, 2020, 07:26:50 PM »
We can go back and forth all day long.  Try paying rent and all your living expenses with zero savings and only getting $454 a week in unemployment.

Try paying rent when you're dead. My state's max is actually $538/week, and my wife works too, so you're talking about over $1k/week to maybe not die. But I think that you're missing the point, I care more about not dying.

Viking Thor

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Re: How long can we wait while flattening the curve?
« Reply #27 on: March 16, 2020, 09:31:13 PM »
I don't know the answer but Walt raises a valid point.

For example 40k people per year in the U.S. die in car accidents with an additional 4m per year injured, some severely debilitated for the rest of their life.

But we don't consider banning  cars.

At some point the economic and convenience benefit to society is deemed to outweigh the health risk. This trade-off is made in countless examples.

If people self quarantine for a year and cause another great depression would that be worth saving some number of lives?  What if the number saved isn't that large?

For what it's worth I agree with social distancing/isolation measures for some period of time but I think it's equally irresponsible to not consider the economic and liberty tradeoffs as it is to just blow it off and let unlucky people suffer the consequences.

PDXTabs

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Re: How long can we wait while flattening the curve?
« Reply #28 on: March 16, 2020, 09:47:27 PM »
If people self quarantine for a year and cause another great depression would that be worth saving some number of lives?

I guess in my mind even if it causes a depression we could restart the economy later and with more people in it, long term we would be better off. That is, long term my stock portfolio would be better off and more people would be alive.

Viking Thor

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Re: How long can we wait while flattening the curve?
« Reply #29 on: March 16, 2020, 10:01:53 PM »
That isn't really logical. If we had a great depression most people would suffer greatly both economically and in terms of their day to day lives. That means years of job insecurity, worry about rent and next meal, etc for tens of millions of people. Essentially misery for an extended period of time for many people.

It may be worth the tradeoff but there is a tradeoff. At some point it's not worth the tradeoff, otherwise we would ban cars or limit them to 15 mph, or other similar measures.

moof

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Re: How long can we wait while flattening the curve?
« Reply #30 on: March 16, 2020, 10:09:37 PM »
I don't know the answer but Walt raises a valid point.

For example 40k people per year in the U.S. die in car accidents with an additional 4m per year injured, some severely debilitated for the rest of their life.

But we don't consider banning  cars.

At some point the economic and convenience benefit to society is deemed to outweigh the health risk. This trade-off is made in countless examples.

If people self quarantine for a year and cause another great depression would that be worth saving some number of lives?  What if the number saved isn't that large?

For what it's worth I agree with social distancing/isolation measures for some period of time but I think it's equally irresponsible to not consider the economic and liberty tradeoffs as it is to just blow it off and let unlucky people suffer the consequences.
Let’s paper napkin this.  A quick google search says there are 809 Million people in this world over 60.  The death rate over 60 is roughly 10%.  So if for the sake of the economy we just ignore it and let this sucker rip through the populace. Would you be OK with 80 Million extra people dying ober the next year?  That is 1000 years of US car deaths worth of seniors dying over a short period of time.  That is about one dead grandparent for every third kid.

Worse yet, these are not “good” deaths, and the death rate would skew higher if we don’t “flatten the curve”.  Boomers coughing and hacking to death unable to get an open hospital bed.  Lots of kids asking why it was too inconvenient to stay at home for a stretch to save her grandparents.  Rough stuff.

A good middle ground might be to test like crazy to make it possible to ease off of some of the broad brush quarantining.
« Last Edit: March 16, 2020, 10:12:11 PM by moof »

PDXTabs

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Re: How long can we wait while flattening the curve?
« Reply #31 on: March 16, 2020, 10:16:03 PM »
If we had a great depression most people would suffer greatly both economically and in terms of their day to day lives.

But why would we have a great depression? The great depression was a time of deflation when we were still on the gold standard and the government was unwilling to deficit spend. I'm not afraid of deflation, we would helicopter money our way out of that if we had to. Which is to say that I'm not afraid of a depression.

PDXTabs

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Re: How long can we wait while flattening the curve?
« Reply #32 on: March 16, 2020, 10:19:36 PM »
Would you be OK with 80 Million extra people dying ober the next year?
...
Worse yet, these are not “good” deaths, and the death rate would skew higher if we don’t “flatten the curve”.  Boomers coughing and hacking to death unable to get an open hospital bed.

Yup, watch grandpa drown in his own fluids and then watch your housing value go down because we just don't need as many houses anymore.

afox

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Re: How long can we wait while flattening the curve?
« Reply #33 on: March 16, 2020, 10:20:58 PM »
The impact of the quarantines seems to be overblown. Food and beverage employs around 4 percent of US workers, tourism another 3-4 percent. A lot of people are not working but still getting paid. A lot of people are still working. A lot of people are working but from home, the best case scenario for the economy and epidemiology but obviously not every worker can work from home. I cant calculate the total economic impact of the quarantines but the economy as a whole has certainly not ground to a halt because of these quarantines.

To estimate some of the economic impacts you all are mentioning would require a lot of work from very highly trained people. If it has'nt been calculated already its probably too late to do for this outbreak. This is why these things are estimated ahead of time based on scenarios, it informs decision making.

About that seat belt or flu analogies- if there were some way to go back in time and temporarily disrupt lives and the economy to save millions of future lives would it be worth it? I think it would. We will have a vaccine for corona at some point, we will better understand how it spreads and how to treat it and there will be some degree of herd-immunity.

Whats needed now is financial relief for those in industries that are heavily affected by corona. The US government is spending billions to prop up share prices for the worlds largest corporations with billions in cash but somehow cant afford 2 weeks of paid sick leave for those that actually get sick from corona. That shows you where the priorities lie.

Luz

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Re: How long can we wait while flattening the curve?
« Reply #34 on: March 17, 2020, 12:16:23 AM »
I asked something similar (posted below) in another thread:

I just read that several Bay Area counties are under orders to "shelter at home" for 3 weeks (if not longer).
I was surprised to learn that, among other things, "shelter at home" means not going to work (for those without the option to work from home and in industries deemed non-essential). Workers facing inevitable job losses were encouraged to apply for unemployment or disability.

I understand that it is all in effort to "flatten the curve," but what good is it for people not to go to their jobs if they can still go to the grocery store and bank? How much is it reducing viral spread, and at what price? Containment to the extent that it affects people's livelihoods seems like a terrible idea, but I must be missing something. "Flatten the curve" is about saving lives and keeping the health sector from being completely overwhelmed, right? But is there a point where the risks involved in containment outweigh the benefits?

Luz

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Re: How long can we wait while flattening the curve?
« Reply #35 on: March 17, 2020, 12:20:21 AM »
I don't know the answer but Walt raises a valid point.

For example 40k people per year in the U.S. die in car accidents with an additional 4m per year injured, some severely debilitated for the rest of their life.

But we don't consider banning  cars.

At some point the economic and convenience benefit to society is deemed to outweigh the health risk. This trade-off is made in countless examples.

If people self quarantine for a year and cause another great depression would that be worth saving some number of lives?  What if the number saved isn't that large?

For what it's worth I agree with social distancing/isolation measures for some period of time but I think it's equally irresponsible to not consider the economic and liberty tradeoffs as it is to just blow it off and let unlucky people suffer the consequences.
Let’s paper napkin this.  A quick google search says there are 809 Million people in this world over 60.  The death rate over 60 is roughly 10%.  So if for the sake of the economy we just ignore it and let this sucker rip through the populace. Would you be OK with 80 Million extra people dying ober the next year?  That is 1000 years of US car deaths worth of seniors dying over a short period of time.  That is about one dead grandparent for every third kid.

Worse yet, these are not “good” deaths, and the death rate would skew higher if we don’t “flatten the curve”.  Boomers coughing and hacking to death unable to get an open hospital bed.  Lots of kids asking why it was too inconvenient to stay at home for a stretch to save her grandparents.  Rough stuff.

A good middle ground might be to test like crazy to make it possible to ease off of some of the broad brush quarantining.

I think you might be talking about the sacrifice or inconvenience of a certain class of people. Working class kids whose parents can't pay the rent or buy food and who've lost their health insurance... different story.

lutorm

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Re: How long can we wait while flattening the curve?
« Reply #36 on: March 17, 2020, 12:44:47 AM »
what good is it for people not to go to their jobs if they can still go to the grocery store and bank?
Well, getting food and having money to pay for it is not optional, going to work is.

How much is it reducing viral spread, and at what price? Containment to the extent that it affects people's livelihoods seems like a terrible idea, but I must be missing something. "Flatten the curve" is about saving lives and keeping the health sector from being completely overwhelmed, right? But is there a point where the risks involved in containment outweigh the benefits?
I guess that depends. What personal chance of death are you willing to trade for how many unemployed in your community?

Luz

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Re: How long can we wait while flattening the curve?
« Reply #37 on: March 17, 2020, 12:51:12 AM »
I'll put this question out there: are we risking a result that would be *worse* than uncontrolled spread of the coronavirus if we completely collapse our economy?

The more people you save the more supply and demand you preserve in the long run. The flatter the curve the more people will survive.

The Government is not going to pay your rent and the Government is not going to give you a paycheck.

There's this thing called unemployment insurance. There's another thing called SNAP. You may remember them from the great recession.


We can go back and forth all day long.  Try paying rent and all your living expenses with zero savings and only getting $454 a week in unemployment.  The average cost of a one bedroom apt in my city is $950 and I live in a LCOL area....  SNAP is also a joke if you are a single male.  They would just assume you starve.  I think they might give you $40 a week, but will turn their nose up at you if you dare tell them you have a car payment.

That's the maximum benefit for one state. My state's max is $240. And it depends on your original earnings. Plus, there's likely a number of dependents to support on that check. And wait times are no joke.

Luz

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Re: How long can we wait while flattening the curve?
« Reply #38 on: March 17, 2020, 01:13:23 AM »
what good is it for people not to go to their jobs if they can still go to the grocery store and bank?
Well, getting food and having money to pay for it is not optional, going to work is.

How much is it reducing viral spread, and at what price? Containment to the extent that it affects people's livelihoods seems like a terrible idea, but I must be missing something. "Flatten the curve" is about saving lives and keeping the health sector from being completely overwhelmed, right? But is there a point where the risks involved in containment outweigh the benefits?
I guess that depends. What personal chance of death are you willing to trade for how many unemployed in your community?

But doesn't getting food and having money to pay for it require going to work? And how effective is containment if many people can't work, but they can do a number of other activities where they're mingling in groups? Just seems a bit odd to me.

I'm not in a high-risk group, so my chances of death are low (though still possible).  I'm all for taking precautions in order to protect those who are vulnerable. But I think it's important to consider what would happen should my family and millions of others like us (without the ability to work remotely and unable to find a new job if employers aren't rehiring) lose our source of income. Where would we sleep? Where would we get our food? What about health insurance? It seems like the effects are much more far-reaching than simply seeing a spike in unemployment.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #39 on: March 17, 2020, 02:02:01 AM »
I feel like it would make more sense to tell all vulnerable groups to isolate themselves (with plenty of support to deliver food/medicine/etc) and let the virus otherwise run rampant through the healthier/younger population until there's some herd immunity in place. Yes, people would die. But I think fewer than we'd get in a depression.

I feel that this is an approach you should feel free to try in your country. Not mine.

six-car-habit

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Re: How long can we wait while flattening the curve?
« Reply #40 on: March 17, 2020, 02:04:04 AM »
The impact of the quarantines seems to be overblown. Food and beverage employs around 4 percent of US workers, tourism another 3-4 percent. A lot of people are not working but still getting paid. A lot of people are still working. A lot of people are working but from home, the best case scenario for the economy and epidemiology but obviously not every worker can work from home.

 The US government is spending billions to prop up share prices for the worlds largest corporations with billions in cash but somehow cant afford 2 weeks of paid sick leave for those that actually get sick from corona. That shows you where the priorities lie.

 In my state they are asking hair salons / barbers / nail salons to close . Also Gyms / fitness clubs / YMCA's .   So that may add another few percent of folks out of work, as I can't see how those skillsets are leveraged thru a computer connection.

 Look to your political parties in America and see which supports employer paid sick time and which doesn't.

 Friends wife works for barbershop on a military base, they want her to take 2 weeks off while they close , [ she works 3 days a week] , they will pay her normal hourly salary "admin" time for 3 days, but want her to take/ use "personal time off" for the other 3 days--- Essentially using 3 days of her vacation time-- but at least she accrues paid time off throughout the year....
« Last Edit: March 17, 2020, 02:06:18 AM by six-car-habit »

Paper Chaser

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Re: How long can we wait while flattening the curve?
« Reply #41 on: March 17, 2020, 03:40:43 AM »

Let’s paper napkin this.  A quick google search says there are 809 Million people in this world over 60.  The death rate over 60 is roughly 10%.  So if for the sake of the economy we just ignore it and let this sucker rip through the populace. Would you be OK with 80 Million extra people dying ober the next year? 

Like a poster above, your math assumes that 100% of a certain demographic would contract this virus and do so immediately. That hasn't happened anywhere yet, and it's unlikely to happen in 12 months as you imply, even if no action were taken. That leads to sensationalism that's not really helpful.

Italy has a population of 60.8 million. About 21% of those people are 65+ for a total of 12.7 million old people according to wikipedia (I know). They've had a total (across all demographics) of 21157 cases and 1441 deaths according to the WHO's latest Situation Report from March 15:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

Even if all of those cases and deaths were in the 65+ demographic, that would mean that just .166% of the most vulnerable demographic has contracted COVID-19 in the 2 months that it's been known to be in Italy. Extrapolate that rate of infection for the global population over 60 that you gave (809 million), and you'd have 1.347 million cases globally. If you're correct, and 10% of those over 60 die after contracting COVID-19, then it would be 134,700 deaths globally which is an insane number of deaths, but it's a far cry from the 80 million that you estimated.

Also, Mean age of those who have died from COVID-19 in Italy is 81 years old, and 2/3 of those had underlying health issues such as diabetes, cancer, cardiovascular disease or a history of smoking:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30627-9/fulltext

It's not afun thought, but how much should be expended trying to save people with very little time left anyway? There's a decent chance that the economic impacts from these shutdowns will outlive a normal 80 year old with other health issues, even if that 80 year old doesn't contract COVID-19.
« Last Edit: March 17, 2020, 04:00:06 AM by Paper Chaser »

cerat0n1a

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Re: How long can we wait while flattening the curve?
« Reply #42 on: March 17, 2020, 03:51:49 AM »
To look at it another way, Hubei province has a population of about 58.5 million, which isn't far off of your UK population estimate of healthy people. They've had 67794 confirmed cases of COVID-19, with 3085 resulting in death over a 4 month period. That means that in the hardest hit place on the planet, 0.11% of the total population has confirmed cases, and 0.0052% of the total population died. That's including the elderly and predisposed.

Run those rates for the UK total population and you'd get 3454 deaths in all of the UK, with a large percentage of those coming from the weakest demographics.

Key difference is China was able to impose (and ensure compliance with) fairly draconian restrictions on interpersonal contact. Europe has mostly left it too late in doing that. There's a reason why Macron is starting every speech by reminding people that the country is on a war footing and has suspended payment of taxes and so on.

Luz

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Re: How long can we wait while flattening the curve?
« Reply #43 on: March 17, 2020, 03:54:56 AM »
It appears that lockdowns may not have been the key to China's success in addressing the virus so far, but more so their testing and quarantine measures.

I thought this interview was also interesting: https://www.npr.org/sections/goatsandsoda/2020/03/08/813401722/who-official-says-coronavirus-containment-remains-possible

The assistant general director of the WHO (or is he AGD of a branch of the WHO?) talks a bit of the importance of applying our understanding of what's driving the virus to efforts to combat it. Right now it seems more reactive and therefore ineffective. I can't help but think that a weakened economy will make the health effects of the coronavirus worse. Why can't we focus our efforts on testing and quarantine rather than travel bans and lockdowns?
« Last Edit: March 17, 2020, 04:03:32 AM by Luz »

Paper Chaser

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Re: How long can we wait while flattening the curve?
« Reply #44 on: March 17, 2020, 04:06:32 AM »
To look at it another way, Hubei province has a population of about 58.5 million, which isn't far off of your UK population estimate of healthy people. They've had 67794 confirmed cases of COVID-19, with 3085 resulting in death over a 4 month period. That means that in the hardest hit place on the planet, 0.11% of the total population has confirmed cases, and 0.0052% of the total population died. That's including the elderly and predisposed.

Run those rates for the UK total population and you'd get 3454 deaths in all of the UK, with a large percentage of those coming from the weakest demographics.

Key difference is China was able to impose (and ensure compliance with) fairly draconian restrictions on interpersonal contact. Europe has mostly left it too late in doing that. There's a reason why Macron is starting every speech by reminding people that the country is on a war footing and has suspended payment of taxes and so on.

The first known COVID-19 case was reported in China in mid-November 2019:

https://www.scmp.com/news/china/society/article/3074991/coronavirus-chinas-first-confirmed-covid-19-case-traced-back

The lockdown in Wuhan began Jan 23, 2020.

That's 2 months for the virus to spread before their draconian policy was implemented.

Once the lockdown was in effect, they were able to get things under control, but it took awhile for them to understand what they were dealing with and how to tackle it. The cat was out of the bag by the time they figured things out and clamped down.
Locking down sooner than China did may end up reducing the impact.
« Last Edit: March 17, 2020, 04:10:44 AM by Paper Chaser »

Travis

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Re: How long can we wait while flattening the curve?
« Reply #45 on: March 17, 2020, 04:16:51 AM »
I think the strategy hasn't been articulated very well.

Simply put, if everyone self-quarantined for 14 days the virus would basically be halted in its tracks.  Obviously that can't/won't happen here but it gives you an idea of what these measures can do.  China basically passed its peak about a month after they publically admitted they had a problem and took drastic measures to combat the spread.  South Korea appears to have done it in just over 2 weeks.



We started going into "lock down" mode across the country 30 days ago after that church in Daegu experienced its outbreak.  The bulk of Korea's infections have stayed in that area to include nearly all the newest infections.  I'm hardly an expert, but it seems like we'd be a great model for Great Britain to follow since we're basically a densely packed island that is heavily dependent on public transportation.

American GenX

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Re: How long can we wait while flattening the curve?
« Reply #46 on: March 17, 2020, 04:33:10 AM »

Some good responses.   I wouldn't even want to think about uncontrolled spread!  That would be devastating.  So, we will just have to prepare for the long depression to follow.

runbikerun

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Re: How long can we wait while flattening the curve?
« Reply #47 on: March 17, 2020, 05:02:27 AM »
I keep seeing the same small number of posters questioning whether the coronavirus is serious enough to warrant the measures being taken.

Some data for you on the spread of coronavirus in Italy:

First confirmed cases: 31st January.
First death: 21st February.
Tenth death: 25th February.
One hundredth death: 4th March.
Lombardy placed on lockdown: 8th March.
Italy placed on lockdown: 10th March.
One thousandth death: 12th March.

Death toll across Italy as I write this: 2,158.
Death rate in Lombardy: 10%.

Read those numbers again. The death toll has gone from zero to over two thousand in less than a month. Confirmed cases have risen by double digits on a daily basis. Of all the populations I'd expect to understand the magic of compounding, MMM would be it. Diagnosis rates are going up by a factor of ten about every twelve days - and this is with the country on lockdown for the last week. Without drastic efforts, we could expect half of Italy to be infected in a little over a month, with three million dead.

I cannot emphasise this enough: based on those numbers, without drastic measures, Italy would lose about five percent of its population in the space of three months and would still be looking at burying more over the following year or so. The speed at which the virus spreads is a critical factor in determining the mortality rate; a hospital system that can cope with five hundred cases a day and sees that number can hold the death toll below one percent, while a hospital system that's overwhelmed appears to be facing a mortality rate ten times higher. Slowing down the rate of infection is the difference between a severe downturn and mass death.

Is three million dead Italians the most likely outcome? Possibly not. But based on the data, it's well within the range of likely outcomes if nothing is done.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #48 on: March 17, 2020, 05:05:31 AM »
We can thus rule out the Italian approach as a useful solution.

runbikerun

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Re: How long can we wait while flattening the curve?
« Reply #49 on: March 17, 2020, 05:13:00 AM »
We can thus rule out the Italian approach as a useful solution.

We can certainly rule out "doing nothing". The lockdown instituted on the 8th of March in Lombardy and the 10th of March across Italy, though, may be working. It took eight days to go from 300 to 3,000 confirmed cases across Italy; it's now been thirteen days since 3,000 and the cases are not yet at 30,000 - it seems as though the rate of spread has slowed down, and that may be reflected more and more in the Italian numbers as days pass. The average daily growth in confirmed cases has slowed to below 20%, which is obviously still terrifying, but substantially better than it was.