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General Discussion => Welcome and General Discussion => Topic started by: waltworks on March 16, 2020, 12:48:37 PM

Title: How long can we wait while flattening the curve?
Post by: waltworks 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
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache 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....
Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate 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
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks 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
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks 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
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 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
Title: Re: How long can we wait while flattening the curve?
Post by: Sanitary Engineer 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.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks 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
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 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?
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks 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
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Adam Zapple 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. 
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser 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.
Title: Re: How long can we wait while flattening the curve?
Post by: BuildingFrugalHabits 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. 
Title: Re: How long can we wait while flattening the curve?
Post by: nereo 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.

Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 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.
Title: Re: How long can we wait while flattening the curve?
Post by: MilesTeg 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Duke03 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. 
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs 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.
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Telecaster 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. 
Title: Re: How long can we wait while flattening the curve?
Post by: YummyRaisins 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Jack0Life 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.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 16, 2020, 07:07:39 PM
This article (https://www.scientificamerican.com/article/why-deaths-from-coronavirus-are-so-high-in-italy/) 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Duke03 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.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Viking Thor 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.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Viking Thor 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.
Title: Re: How long can we wait while flattening the curve?
Post by: moof 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.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs 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.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs 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.
Title: Re: How long can we wait while flattening the curve?
Post by: afox 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Luz 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?
Title: Re: How long can we wait while flattening the curve?
Post by: Luz 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.
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm 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?
Title: Re: How long can we wait while flattening the curve?
Post by: Luz 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Luz 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Kyle Schuant 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.
Title: Re: How long can we wait while flattening the curve?
Post by: six-car-habit 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....
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser 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.
Title: Re: How long can we wait while flattening the curve?
Post by: cerat0n1a 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Luz 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?
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Travis 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.
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX 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.
Title: Re: How long can we wait while flattening the curve?
Post by: runbikerun 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Kyle Schuant on March 17, 2020, 05:05:31 AM
We can thus rule out the Italian approach as a useful solution.
Title: Re: How long can we wait while flattening the curve?
Post by: runbikerun 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.
Title: Re: How long can we wait while flattening the curve?
Post by: Kyle Schuant on March 17, 2020, 05:17:23 AM
They're not testing much. Even if no further person got infected, the numbers would eventually go up as they got tested or, as is happening a lot in Italy, autopsied.

If only we lived in advanced countries like India.

https://www.abc.net.au/news/2020-03-17/india-is-containing-coronavirus-despite-dense-population/12059024
Title: Re: How long can we wait while flattening the curve?
Post by: runbikerun on March 17, 2020, 03:13:44 PM
The Taoiseach is addressing the nation here in Ireland right now - the plan appears to be to 1) get people onto income support as quickly as possible, 2) keep things as they are for the next few weeks, and 3) at some point in the future, "cocoon" vulnerable people for a period of several weeks with full food delivery and on-call medical staff. It sounds as though the plan is to bring numbers as low as possible as quickly as possible, and then use the time that buys to let the virus rip through the population in a single sustained burst (although I am absolutely speculating here).
Title: Re: How long can we wait while flattening the curve?
Post by: Telecaster on March 17, 2020, 03:19:37 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.

Co-signed.  This isn't like 2008 when we had a system banking problem.   As far as I can tell the guts of the economy are fine. 
Title: Re: How long can we wait while flattening the curve?
Post by: rocketpj on March 17, 2020, 04:13:19 PM
From a long-term perspective a crash like this can have a net positive financial effect, basically clearing out all the overleveraged doomed companies as they crash (i.e. Uber).  Better situated companies will be able to come in and buy up the good bits while discarding all the garbage and debt.  We saw something similar in the dot com crash - lots of debt to build out the infrastructure, crash and burn, infrastructure remains and taken up by stronger survivors.

That said, bad for shareholders of individual stocks, bad for employees.  This is going to be a tough decade.

All the critical weaknesses of capitalism as a system are on display.  We may end up with something else by the time the dust settles.  No, this is not an infantile binary capitalism vs Stalinism situation, but we may see some of the things that should probably be operated as common goods become just that.

The most obvious example is health care.  A health care system that is optimized for profit maximization and extraction is by design not going to be able to handle sudden surges in demand, especially if it is combined with strong individual disincentives to actually using the system (i.e. high costs).  If it breaks, which it looks like it will, I don't see it being replaced by more of the same with the same weaknesses built in.

Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 17, 2020, 06:12:11 PM
Imperial College says that flattening the curve (ideally) will reduce the death toll from 2.2 million to 1.1 million (https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf) in the USA. That is, they model that flattening the curve (enough) is worth 1.0~1.1 million US lives.
Title: Re: How long can we wait while flattening the curve?
Post by: Viking Thor on March 18, 2020, 05:53:41 PM
We don't know for sure if it's 1m lives or 10k lives that could be saved or how much time period of quarantine/distancing is required. We also don't know the economic impact, there are estimates that up to 80m jobs in the U.S could be at some level of risk (looking at all the jobs in restaurants, travel, etc).
https://www.cnn.com/2020/03/16/economy/job-losses-coronavirus/index.html

No one i think is arguing against a period of social distancing now to begin with, but at some point if this continues you would see a period like nothing in modern times- i.e in the history of the modern world there has never been an example where huge portions of the entire economy were mandated to stop for 12-18 months.

There are already many layoffs now and we just started, in 3 months there would be an avalanche.

If handled poorly more people could die related to poverty and losing access to healthcare (to treat non-corona health issues) than are saved by social distancing for 12-18 months and driving the economy off a cliff.
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 18, 2020, 08:01:58 PM
No one i think is arguing against a period of social distancing now to begin with, but at some point if this continues you would see a period like nothing in modern times-

No one says it has to go on forever.  But it has to for now to prevent the healthcare system from being overwhelmed.  In fact, we may have not buckled down as quickly and significantly as we should have, but we have to ride this out for NOW.  The future will be arriving very soon.  Adjustments can be made then if and when they are needed.
Title: Re: How long can we wait while flattening the curve?
Post by: Viking Thor on March 18, 2020, 09:13:14 PM
that I agree with, we didn't do enough (in the U.S.) to start with and didn't take it serious enough for a long time. My fear is that eventually switches to the opposite extreme, where we shut things down for way too long.

I know 3 people already that have lost their job. Some of the experts now saying it could take 12-18 months for the corona virus to be under control.

We can afford a couple of months of economic shut down but at some point the costs would be astronomic. We should also be looking at what other countries do - frankly we are handling it the worst other than maybe Italy. Other countries had high cases in the beginning and it's calmed down now. E.g. In Japan they did not have to shut down restaurants, gyms, etc but they did shut down schools early on.
Title: Re: How long can we wait while flattening the curve?
Post by: Jack0Life on March 18, 2020, 11:08:05 PM
More and more, this thread makes a good point.
This country can maybe handle the shutdown till the end of April.
Things have to get rolling again or else economically the devastation maybe be worst.
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 19, 2020, 04:59:07 AM

How long?

The latest news is that the government is preparing for 18 months of waves of COVID-19.

https://www.cnn.com/2020/03/19/health/us-coronavirus-case-updates-thursday/index.html
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 19, 2020, 08:23:02 AM
John P.A. Ioannidis is professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanford’s Meta-Research Innovation Center:

Quote
The data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable. Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 are being missed. We don’t know if we are failing to capture infections by a factor of three or 300. Three months after the outbreak emerged, most countries, including the U.S., lack the ability to test a large number of people and no countries have reliable data on the prevalence of the virus in a representative random sample of the general population.

This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.

Basically, we are making decisions with extremely shitty data.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/
Title: Re: How long can we wait while flattening the curve?
Post by: runbikerun on March 19, 2020, 08:36:38 AM
People still seem unwilling to face just how dire this situation is. Infection rates in a situation where serious measures are not taken are running at perhaps eight days to multiply numbers by ten. Lombardy is running out of coffins. Its doctors are showing PTSD symptoms. The mortality rate is effectively 10% thanks to a completely overrun medical system.

Whatever your mental model is for how bad this is, forget it. It's far, far worse. See my mention of Lombardy above? They had their first coronavirus positive less than a month ago. There is a reason governments are mobilising on this scale; it's because left to its own devices, this will kill more people than the world wars, and it will do it in weeks.

If your state has a population of ten million, and isn't taking serious measures, here's a fairly likely trajectory.

Today: the first case in your state.
Eight days from now: the tenth case in your state.
Sixteen days from now: the hundredth case in your state, and the first few deaths.
Twenty-four days from now: deaths are now beginning to add up.
Thirty-two days from now: deaths at this point are running at close to one in ten, as your medical system becomes completely overrun.
Forty days from now, assuming still no measures being taken: about a hundred thousand cases by now, and almost ten thousand deaths. There is a shortage of coffins. Medical personnel are showing PTSD symptoms; some are dying. Decisions are regularly being made to leave patients to die because there are not enough ventilators.
Forty-eight days from now: close to a million infected. Almost one percent of the population has died of coronavirus in less than seven weeks. The medical system is effectively gone at this point. Corpses are being piled up in warehouses because there's no room left.
Fifty-six days from now: at this point, the infection rate is levelling off as 90% or so of the population has contracted coronavirus. There are thousands upon thousands of deaths on a daily basis. The piles of corpses lead to a secondary outbreak of bacterial and parasitical illnesses, a considerable number of which will end up killing their hosts as a result of an already weakened immune system. Of the ten million people in your state, close to a million are dead or dying. The hospital system will take years to recover, and the state faces a desperate shortage of doctors and nurses.

If this is not prevented, it will be the worst loss of life in Europe and America in centuries.

At this point, eight weeks have passed. In a little under two months, your state has lost almost 10% of its population, its support and safety structures have been utterly ruined, the economy is wrecked completely, and (assuming you survive) you'll be mourning your friends and family for years to come.
Title: Re: How long can we wait while flattening the curve?
Post by: Telecaster on March 19, 2020, 09:12:40 AM
People still seem unwilling to face just how dire this situation is. Infection rates in a situation where serious measures are not taken are running at perhaps eight days to multiply numbers by ten. Lombardy is running out of coffins. Its doctors are showing PTSD symptoms. The mortality rate is effectively 10% thanks to a completely overrun medical system.

Whatever your mental model is for how bad this is, forget it. It's far, far worse. See my mention of Lombardy above? They had their first coronavirus positive less than a month ago. There is a reason governments are mobilising on this scale; it's because left to its own devices, this will kill more people than the world wars, and it will do it in weeks.

If your state has a population of ten million, and isn't taking serious measures, here's a fairly likely trajectory.

Today: the first case in your state.
Eight days from now: the tenth case in your state.
Sixteen days from now: the hundredth case in your state, and the first few deaths.
Twenty-four days from now: deaths are now beginning to add up.
Thirty-two days from now: deaths at this point are running at close to one in ten, as your medical system becomes completely overrun.
Forty days from now, assuming still no measures being taken: about a hundred thousand cases by now, and almost ten thousand deaths. There is a shortage of coffins. Medical personnel are showing PTSD symptoms; some are dying. Decisions are regularly being made to leave patients to die because there are not enough ventilators.
Forty-eight days from now: close to a million infected. Almost one percent of the population has died of coronavirus in less than seven weeks. The medical system is effectively gone at this point. Corpses are being piled up in warehouses because there's no room left.
Fifty-six days from now: at this point, the infection rate is levelling off as 90% or so of the population has contracted coronavirus. There are thousands upon thousands of deaths on a daily basis. The piles of corpses lead to a secondary outbreak of bacterial and parasitical illnesses, a considerable number of which will end up killing their hosts as a result of an already weakened immune system. Of the ten million people in your state, close to a million are dead or dying. The hospital system will take years to recover, and the state faces a desperate shortage of doctors and nurses.

If this is not prevented, it will be the worst loss of life in Europe and America in centuries.

At this point, eight weeks have passed. In a little under two months, your state has lost almost 10% of its population, its support and safety structures have been utterly ruined, the economy is wrecked completely, and (assuming you survive) you'll be mourning your friends and family for years to come.

But that nice Mr. Trump assured us the cases numbers were going down and it would disappear like a "miracle." 
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on March 19, 2020, 09:13:29 AM
John P.A. Ioannidis is professor of medicine, of epidemiology and population health, of biomedical data science, and of statistics at Stanford University and co-director of Stanford’s Meta-Research Innovation Center:

Quote
The data collected so far on how many people are infected and how the epidemic is evolving are utterly unreliable. Given the limited testing to date, some deaths and probably the vast majority of infections due to SARS-CoV-2 are being missed. We don’t know if we are failing to capture infections by a factor of three or 300. Three months after the outbreak emerged, most countries, including the U.S., lack the ability to test a large number of people and no countries have reliable data on the prevalence of the virus in a representative random sample of the general population.

This evidence fiasco creates tremendous uncertainty about the risk of dying from Covid-19. Reported case fatality rates, like the official 3.4% rate from the World Health Organization, cause horror — and are meaningless. Patients who have been tested for SARS-CoV-2 are disproportionately those with severe symptoms and bad outcomes. As most health systems have limited testing capacity, selection bias may even worsen in the near future.

Basically, we are making decisions with extremely shitty data.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

Great Argument! Except that people are dying in droves in Italy because the medical system is overwhelmed.

Title: Re: How long can we wait while flattening the curve?
Post by: bacchi on March 19, 2020, 10:00:15 AM
People still seem unwilling to face just how dire this situation is. Infection rates in a situation where serious measures are not taken are running at perhaps eight days to multiply numbers by ten. Lombardy is running out of coffins. Its doctors are showing PTSD symptoms. The mortality rate is effectively 10% thanks to a completely overrun medical system.

Yes.

It's not about a 1-3% death rate for elderly people. It's about the number of hospital beds and ventilators needed all at once. Some people are going to get triaged to the morgue if hospitals are overwhelmed.

Think about it. There are only 160k ventilators total in the US. If only 5% in the US get coronavirus during the same 2 week span, and only 5% of them need breathing help (far less than what China saw), we're SOL.
Title: Re: How long can we wait while flattening the curve?
Post by: GettingClose on March 19, 2020, 10:35:27 AM
It's wrong to assume that only older people are at risk: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w (https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w)  This report covers 508 COVID-19 cases in the US resulting in hospitalization.

Quote
Among 121 patients known to have been admitted to an ICU, 7% of cases were reported among adults ≥85 years, 46% among adults aged 65–84 years, 36% among adults aged 45–64 years, and 12% among adults aged 20–44 years (Figure 2). No ICU admissions were reported among persons aged ≤19 years. Percentages of ICU admissions were lowest among adults aged 20–44 years (2%–4%) and highest among adults aged 75–84 years (11%–31%)

48% of ICU admissions were in people < 65 years old.
From other data in the report:
55% of hospitalizations were in people < 65 years old.
20% of deaths were in people < 65 years old.

Interestingly no one under the age of 20 appeared to have been hospitalized or to have died.

There are various ways to pick the numbers apart, but it's clearly not a matter of "isolate everyone over 65 and let the disease take its toll on everyone else".  We're days away from a major healthcare crisis.  In my state all elective medical procedures, dental procedures, and veterinary procedures have been halted by order of the governor, to preserve PPE.
Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate on March 19, 2020, 11:01:13 AM
It's wrong to assume that only older people are at risk: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w (https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm?s_cid=mm6912e2_w)  This report covers 508 COVID-19 cases in the US resulting in hospitalization.

Who is saying that only older people are at risk? I certainly haven't heard anyone argue that healthy 70 year olds need to isolate themselves while 40 year old cancer patients on chemotherapy should continue as normal.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 19, 2020, 11:05:09 AM
48% of ICU admissions were in people < 65 years old.

In The Netherlands a full half of ICU patients are under 50.  https://www.washingtonpost.com/health/2020/03/19/younger-adults-are-large-percentage-coronavirus-hospitalizations-united-states-according-new-cdc-data/
Title: Re: How long can we wait while flattening the curve?
Post by: nemesis on March 19, 2020, 11:32:37 AM
48% of ICU admissions were in people < 65 years old.

In The Netherlands a full half of ICU patients are under 50.  https://www.washingtonpost.com/health/2020/03/19/younger-adults-are-large-percentage-coronavirus-hospitalizations-united-states-according-new-cdc-data/
The data is chilling.

This is far more serious than saving jobs / economy at this moment.  No wonder China reacted with such draconian measures that are unprecedented in history during times of peace.

I spoke with 2 friends last night by phone who still weren't getting it.  "Oh it's just the flu" "more people die every year than this by the flu" "My parents are healthy and have a great immune system"...

No you dummies (my friends) - get your head out of the sand and learn how serious this is.
Title: Re: How long can we wait while flattening the curve?
Post by: itchyfeet on March 19, 2020, 11:41:02 AM
Not just China.

The world has woken up this week and is taking very dramatic steps.

The next two weeks of global social distancing will see COVD-19 completely eradicated from some countries that don’t really have social transmission within the country yet, and the growth of cases in other more affected countries will have been thoroughly wound back. From this point the world should be able to slowly start operating again in a cautious way, more prepared and more educated way. Look how fast China and Korea stopped the growth in cases once they got serious. Countries like Singapore have controlled the break out of the virus quite well.

There is hope. At least I choose to believe so.
Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 19, 2020, 04:29:34 PM
I have no doubt that the current draconian social isolation measures in most countries will see the pandemic relegated to very handle-able proportions in most countries (and those in which it still rages will be cut off from other countries). Just have a look at how China and Japan and Singapore have been able to halt the spread of the virus. Even here in Australia, it's been weeks since the outbreak and we are still running in single figure deaths.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 19, 2020, 04:36:33 PM
I’m not certain it would actually play out this way here, but lately I’ve been thinking that once an epidemic hits some critical psychological threshold [almost] everyone goes into full lockdown mode from panic, which in turn halts all further spread. 

That’s why I’m still skeptical of any 7-figure mortality estimates for within the US.  People can shrug off 1,000 deaths or maybe even 10,000, but if/when the death toll starts being thousands per day I’m betting >90% of the population will lock themselves in their homes and not venture out.  Of course this will be in tandem with ever-more-strict governmental decrees.

...which is basically what happened in Wuhan Provence in Chaina. It got super-bad; hundreds were dying daily, and then transmission rates went to near-zero as everyone became afraid to be anywhere near another person not in their family.

...just some evening ramblings.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on March 19, 2020, 05:13:32 PM
I believe that the debate is academic at this point. The schools are locked down, the tourism industry is crushed as is hospitality. The technical definition of a depression is a 10% drop in real GDP. We are where we are. We’re going to have a depression.

The choice is whether we make the best of that, crush this pestilence, and go onto a better future next year, or do we get both a depression AND a lot of unnecessarily dead people due to half measures? And a worse depression as a booby prize?

 I see a lot of potential good and some great coming of this in the long run. It will suck extremely  mightily in the short term. That’s the card we’ve been dealt.

Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 19, 2020, 05:21:37 PM
48% of ICU admissions were in people < 65 years old.

In The Netherlands a full half of ICU patients are under 50.  https://www.washingtonpost.com/health/2020/03/19/younger-adults-are-large-percentage-coronavirus-hospitalizations-united-states-according-new-cdc-data/

Yes, we need these young people to listen and stop congregating in large crowds.  They were told to avoid that to protect against spreading to the vulnerable, but many young healthy people will find they aren't so invulnerable, so they are protecting themselves as well by self-quarantining as much as possible.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on March 19, 2020, 05:31:48 PM
I have no doubt that the current draconian social isolation measures in most countries will see the pandemic relegated to very handle-able proportions in most countries (and those in which it still rages will be cut off from other countries). Just have a look at how China and Japan and Singapore have been able to halt the spread of the virus. Even here in Australia, it's been weeks since the outbreak and we are still running in single figure deaths.

That's because it's slow right up until it explodes. This is exactly what happened in China and Italy. Hopefully, Aus implemented those measures in time.
Title: Re: How long can we wait while flattening the curve?
Post by: Kyle Schuant on March 19, 2020, 05:42:28 PM
Hopefully, Aus implemented those measures in time.
The people are ahead of government measures. The government wants schools to remain open, but 1/4-1/3 of children have been removed by their parents. The government is now saying that restaurants etc can have one person per 4m2 of venue - but the places are deserted anyway.

https://www.abc.net.au/news/2020-03-20/coronavirus-covid-should-kids-go-to-school/12071336

https://www.abc.net.au/news/2020-03-20/coronavirus-queensland-restaurants-cancellations-deliveries/12064292
Title: Re: How long can we wait while flattening the curve?
Post by: RetiredAt63 on March 19, 2020, 05:57:28 PM
An Air Canada gate agent told me they are seeing lots of domestic cancellations.  My domestic flight thst showed fully booked online had lots of empty seats.  Flights are being amalgamated because of lots of cancellations. Canadians seem to be taking it seriously.  Having a self-isolated Prime Minister probably helps this attitude.
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on March 19, 2020, 06:23:05 PM
I have no doubt that the current draconian social isolation measures in most countries will see the pandemic relegated to very handle-able proportions in most countries (and those in which it still rages will be cut off from other countries). Just have a look at how China and Japan and Singapore have been able to halt the spread of the virus. Even here in Australia, it's been weeks since the outbreak and we are still running in single figure deaths.

That's because it's slow right up until it explodes. This is exactly what happened in China and Italy. Hopefully, Aus implemented those measures in time.

Yes. The numbers in my state have increased by more than 10-fold in 9 days, and those are just the cases we know about. We’ve also seen our first 3 deaths in the last 24 hours. This is with a full shut-down of all schools and municipal buildings and many businesses.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 19, 2020, 07:00:20 PM
I believe that the debate is academic at this point. The schools are locked down, the tourism industry is crushed as is hospitality. The technical definition of a depression is a 10% drop in real GDP. We are where we are. We’re going to have a depression.


Maybe?  I’m far from convinced at this point.  Consider the 1918 flu coincided with the First World War. 
675,000 Americans died from the flu when the population was just 1/3 of present levels.  WWI killed an additional 115,000 a year beforehand.
Adjusting for inflation that would be 1.9MM deaths.  We are a very long way from that.

Yet what followed wasn’t a depression but one of the greatest market run ups in history (which ended in a depression a decade later).

The US economy is incredibly complex and surprisingly resilient.  Some forecasts I’ve seen suggest lost economic activity around $900B this year, but some of that will be offset by governmental bailouts.  To drop 10% we’d need a net loss of around $2.2T. Businesses are shuttered right now, but some (much?) of that is simply delayed... for a few weeks at least, possibly for several months. Other losses are permanent and can’t be replaced.

Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on March 19, 2020, 07:12:07 PM
Hopefully, Aus implemented those measures in time.
The people are ahead of government measures. The government wants schools to remain open, but 1/4-1/3 of children have been removed by their parents. The government is now saying that restaurants etc can have one person per 4m2 of venue - but the places are deserted anyway.

https://www.abc.net.au/news/2020-03-20/coronavirus-covid-should-kids-go-to-school/12071336

https://www.abc.net.au/news/2020-03-20/coronavirus-queensland-restaurants-cancellations-deliveries/12064292

That’s pretty much the case here. Restaurants are empty, schools are closed, traffic is Christmas holidays light. Even the bars that are still open seem quiet. And then you see some idiots hanging in groups close to each other. A mixed bag but better than I expected.
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on March 19, 2020, 07:17:55 PM
Yes. The numbers in my state have increased by more than 10-fold in 9 days, and those are just the cases we know about. We’ve also seen our first 3 deaths in the last 24 hours. This is with a full shut-down of all schools and municipal buildings and many businesses.

I'd guess that a very large part of the recent increases comes just as much from people finally being tested as it does from the virus spreading. In other words, a bunch of those new confirmed cases probably had the virus 9 days ago when the numbers in your state were lower, we just didn't have a way to confirm it.
Title: Re: How long can we wait while flattening the curve?
Post by: Acorns on March 19, 2020, 08:05:55 PM

If your state has a population of ten million, and isn't taking serious measures, here's a fairly likely trajectory.

Today: the first case in your state.
Eight days from now: the tenth case in your state.
Sixteen days from now: the hundredth case in your state, and the first few deaths.
Twenty-four days from now: deaths are now beginning to add up.
Thirty-two days from now: deaths at this point are running at close to one in ten, as your medical system becomes completely overrun.
Forty days from now, assuming still no measures being taken: about a hundred thousand cases by now, and almost ten thousand deaths. There is a shortage of coffins. Medical personnel are showing PTSD symptoms; some are dying. Decisions are regularly being made to leave patients to die because there are not enough ventilators.
Forty-eight days from now: close to a million infected. Almost one percent of the population has died of coronavirus in less than seven weeks. The medical system is effectively gone at this point. Corpses are being piled up in warehouses because there's no room left.
Fifty-six days from now: at this point, the infection rate is levelling off as 90% or so of the population has contracted coronavirus. There are thousands upon thousands of deaths on a daily basis. The piles of corpses lead to a secondary outbreak of bacterial and parasitical illnesses, a considerable number of which will end up killing their hosts as a result of an already weakened immune system. Of the ten million people in your state, close to a million are dead or dying. The hospital system will take years to recover, and the state faces a desperate shortage of doctors and nurses.

If this is not prevented, it will be the worst loss of life in Europe and America in centuries.

At this point, eight weeks have passed. In a little under two months, your state has lost almost 10% of its population, its support and safety structures have been utterly ruined, the economy is wrecked completely, and (assuming you survive) you'll be mourning your friends and family for years to come.

Posts like this are just fear mongering. Yes, coronavirus is scary and deadly, highly transmittable and certainly more deadly than the average flu, but the United States isn't Italy and we shouldn't expect our outcomes to be the same as theirs. How do I know this? In direct contrast to the projections in the above post, coronavirus has been circulating in my state for almost 2 months and only .001% of our population has died from it, and that is with zero preventative/social distancing measures until two weeks ago. There are likely thousands of unreported/untested cases but only .02% of the state's population has gotten sick enough from it to be tested for it. We are younger, healthier, fewer smokers, less "handsy" in general, don't practice kissing as a social greeting, etc.

I am practicing social distancing. Have been to the grocery store twice this week but that is the only time I have left the house. But if we are going to make this worth the huge economic toll this will take on our country, it has to be all in, a nation wide lock down if necessary. At some point (soon!) we all have to go back to work or else we risk a total economic collapse. My grandmother is 85 and figures she is going to die in the next 10 years one way or another, but she really doesn't want to die destitute.
Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 19, 2020, 08:13:40 PM
People still seem unwilling to face just how dire this situation is. Infection rates in a situation where serious measures are not taken are running at perhaps eight days to multiply numbers by ten. Lombardy is running out of coffins. Its doctors are showing PTSD symptoms. The mortality rate is effectively 10% thanks to a completely overrun medical system.

Whatever your mental model is for how bad this is, forget it. It's far, far worse. See my mention of Lombardy above? They had their first coronavirus positive less than a month ago. There is a reason governments are mobilising on this scale; it's because left to its own devices, this will kill more people than the world wars, and it will do it in weeks.

If your state has a population of ten million, and isn't taking serious measures, here's a fairly likely trajectory.

Today: the first case in your state.
Eight days from now: the tenth case in your state.
Sixteen days from now: the hundredth case in your state, and the first few deaths.
Twenty-four days from now: deaths are now beginning to add up.
Thirty-two days from now: deaths at this point are running at close to one in ten, as your medical system becomes completely overrun.
Forty days from now, assuming still no measures being taken: about a hundred thousand cases by now, and almost ten thousand deaths. There is a shortage of coffins. Medical personnel are showing PTSD symptoms; some are dying. Decisions are regularly being made to leave patients to die because there are not enough ventilators.
Forty-eight days from now: close to a million infected. Almost one percent of the population has died of coronavirus in less than seven weeks. The medical system is effectively gone at this point. Corpses are being piled up in warehouses because there's no room left.
Fifty-six days from now: at this point, the infection rate is levelling off as 90% or so of the population has contracted coronavirus. There are thousands upon thousands of deaths on a daily basis. The piles of corpses lead to a secondary outbreak of bacterial and parasitical illnesses, a considerable number of which will end up killing their hosts as a result of an already weakened immune system. Of the ten million people in your state, close to a million are dead or dying. The hospital system will take years to recover, and the state faces a desperate shortage of doctors and nurses.

If this is not prevented, it will be the worst loss of life in Europe and America in centuries.

At this point, eight weeks have passed. In a little under two months, your state has lost almost 10% of its population, its support and safety structures have been utterly ruined, the economy is wrecked completely, and (assuming you survive) you'll be mourning your friends and family for years to come.

OK, so in about six weeks' time, I should expect 10% of my state's population to be dead, and I will be mourning friends and family members.

Is that a 50th percentile EV, or is it a 99.9th percentile worst case scenario? Because the two are very different.

If you are particularly susceptible to something, you might run at 99.9th percentile survey. For the rest of us, this comes across as fear-mongering. Based on the available data, if the entire population got the virus a lot less than 10% would be dead, and most of the dead would not be young or healthy individuals.

Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 19, 2020, 08:20:20 PM
In direct contrast to the projections in the above post, coronavirus has been circulating in my state for almost 2 months and only .001% of our population has died from it. There are likely thousands of unreported/untested cases but only .02% of the state's population has gotten sick enough from it to be tested for it.
I'm not sure you understand how this progresses. The absolute numbers are less important than how they change. An exponential is very flat at the beginning, but once it turns up it's breathtaking. The projections above were for no countermeasures. Social distancing will slow the increase, so the doubling time is longer. But I'd be very surprised if the case numbers won't keep on doubling for a while. I'd love to be wrong, but I think we are far from the peak. The social distancing is just getting underway and many people and businesses still seem to think it's nothing to worry about.
Title: Re: How long can we wait while flattening the curve?
Post by: Viking Thor on March 19, 2020, 08:31:25 PM
The point everyone is overlooking is that the fatality rate is likely far lower than the calculated numbers, which are based on test confirmed cases. And by all expert accounts there are way more cases that are not reported both in the U.S. and places like China where it peaked already.

So the 2% mortality rate might easilly be 10 times lower, because most people that have it don't report it And recover in their own. And a 10% death rate is not something that is in any way supported by evidence and this has now been around for several months. Yes it's a serious problem and we should do social distancing but it seems like in the U.S. the pendulum has swung from initial denial/bury head in sand foolishness to fear mongering and representing a worst case scenario out to be 100%  certainty.
Title: Re: How long can we wait while flattening the curve?
Post by: ender on March 19, 2020, 08:36:09 PM
The point everyone is overlooking is that the fatality rate is likely far lower than the calculated numbers, which are based on test confirmed cases. And by all expert accounts there are way more cases that are not reported both in the U.S. and places like China where it peaked already.

So the 2% mortality rate might easilly be 10 times lower, because most people that have it don't report it And recover in their own. And a 10% death rate is not something that is in any way supported by evidence and this has now been around for several months. Yes it's a serious problem and we should do social distancing but it seems like in the U.S. the pendulum has swung from initial denial/bury head in sand foolishness to fear mongering and representing a worst case scenario out to be 100%  certainty.

This is where the Diamond Princess "experiment" starts becoming interesting from a percentages perspective.

It's a little tricky to fully represent given it was early enough that everyone was able to receive full medical care.
Title: Re: How long can we wait while flattening the curve?
Post by: Viking Thor on March 19, 2020, 08:40:39 PM
Right, I wish the sky is falling crowd would read this article from a respected Stanford University Epidemiologist and researcher.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/
Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 19, 2020, 08:45:20 PM
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.

Which is why I think newspapers talking about exponential growth are doing us a disservice. According to the WHO numbers, the rate of infection is nothing like an exponential function. Just because for a few days in a row there are more infections each day than in the day previous does not make a function 'exponential', otherwise in about 30 days everyone on earth would be infected.

Title: Re: How long can we wait while flattening the curve?
Post by: ender on March 19, 2020, 08:46:57 PM
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.

Which is why I think newspapers talking about exponential growth are doing us a disservice. According to the WHO numbers, the rate of infection is nothing like an exponential function. Just because for a few days in a row there are more infections each day than in the day previous does not make a function 'exponential', otherwise in about 30 days everyone on earth would be infected.

The limiting factor is actually testing too.

I'd be very curious to see numbers of tests administered/available vs these growth rate charts. I suspect they'd be oddly correlated.
Title: Re: How long can we wait while flattening the curve?
Post by: Acorns on March 19, 2020, 08:58:20 PM
In direct contrast to the projections in the above post, coronavirus has been circulating in my state for almost 2 months and only .001% of our population has died from it. There are likely thousands of unreported/untested cases but only .02% of the state's population has gotten sick enough from it to be tested for it.
I'm not sure you understand how this progresses. The absolute numbers are less important than how they change. An exponential is very flat at the beginning, but once it turns up it's breathtaking. The projections above were for no countermeasures. Social distancing will slow the increase, so the doubling time is longer. But I'd be very surprised if the case numbers won't keep on doubling for a while. I'd love to be wrong, but I think we are far from the peak. The social distancing is just getting underway and many people and businesses still seem to think it's nothing to worry about.

My state had no countermeasures until 2 weeks ago, even now we are far from total lockdown. Cases in the state have gone from 1 to 1370 (probably many more untested). I don't know what rate of growth that is but it is way less than the 90% infection rate cited in the original scenario I responded to.
Title: Re: How long can we wait while flattening the curve?
Post by: Boofinator on March 19, 2020, 09:52:38 PM
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.

Which is why I think newspapers talking about exponential growth are doing us a disservice. According to the WHO numbers, the rate of infection is nothing like an exponential function. Just because for a few days in a row there are more infections each day than in the day previous does not make a function 'exponential', otherwise in about 30 days everyone on earth would be infected.

The rate of infection for a novel virus in a virgin population is absolutely exponential. Technically, it is a logistic function, but at the lower limit it devolves to an exponential, which is what we're seeing. At some point, one of two things will happen to break the exponential growth: 1) the exponential growth becomes saturated by recovered individuals, and the disease falls off as the logistic curve, and/or 2) people change their behaviors in response to the disease (or perhaps the disease becomes less communicable due to the weather), so that the function stays exponential but the growth rate decreases significantly (in the case of China and a few other countries, they've managed to achieve a negative exponential growth rate). The current approach the world seems to have settled on is #2, though I doubt every country will be able to achieve a negative growth rate prior to a vaccine being implemented.

Here's an example of the derivation: https://math.stackexchange.com/questions/137087/rate-of-infection-in-a-population (https://math.stackexchange.com/questions/137087/rate-of-infection-in-a-population)
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 19, 2020, 10:13:47 PM
The rate of infection for a novel virus in a virgin population is absolutely exponential. Technically, it is a logistic function, but at the lower limit it devolves to an exponential, which is what we're seeing. At some point, one of two things will happen to break the exponential growth: 1) the exponential growth becomes saturated by recovered individuals, and the disease falls off as the logistic curve, and/or 2) people change their behaviors in response to the disease (or perhaps the disease becomes less communicable due to the weather), so that the function stays exponential but the growth rate decreases significantly.
Exactly, countermeasures do not prevent exponential growth, they just make it slower, and a slow exponential is still pretty bad unless it gets a lot slower.

This (https://www.google.com/url?q=https://www.nytimes.com/2020/03/13/science/coronavirus-math-mitigation-distancing.html&sa=D&source=hangouts&ust=1584761861634000&usg=AFQjCNF7Y-snojKjIfR4mmadeM051chNVw) was a pretty good article today on growth rates.
Title: Re: How long can we wait while flattening the curve?
Post by: Reader on March 20, 2020, 04:36:31 AM
My state had no countermeasures until 2 weeks ago, even now we are far from total lockdown. Cases in the state have gone from 1 to 1370 (probably many more untested). I don't know what rate of growth that is but it is way less than the 90% infection rate cited in the original scenario I responded to.

watch what is happening to the italians. their numbers should be reliable. in about a week, the state may reach 5000+ cases if the infection rate is similar to italy.

https://www.reddit.com/r/dataisbeautiful/comments/fhykic/oc_this_chart_comparing_infection_rates_between/
Title: Re: How long can we wait while flattening the curve?
Post by: MayDay on March 20, 2020, 05:33:27 AM
My state had no countermeasures until 2 weeks ago, even now we are far from total lockdown. Cases in the state have gone from 1 to 1370 (probably many more untested). I don't know what rate of growth that is but it is way less than the 90% infection rate cited in the original scenario I responded to.

watch what is happening to the italians. their numbers should be reliable. in about a week, the state may reach 5000+ cases if the infection rate is similar to italy.

https://www.reddit.com/r/dataisbeautiful/comments/fhykic/oc_this_chart_comparing_infection_rates_between/

I do not think we will see that growth in the US because there literally are not tests. So they are hoarding tests just like toilet paper.

If you aren't admitted to the hospital or a celebrity or healthcare worker, no test.
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 20, 2020, 08:33:36 AM
@waltworks I'd be shocked if we last more than a month.  At some point, businesses are going to open their doors rather than go out of business.  Parents are going to insist that schools reopen, because they need to go to work and they need some relief from childcare.

I read an interesting piece in the NYT by an historian of the 1918 flu.  The part that stuck out to me was that even the army, in wartime, wasn't able to maintain effective quarantines for long enough to matter all that much.  We as humans just aren't wired for extended periods of isolation.  If a wartime army a hundred years ago couldn't do it, I highly doubt ordinary Americans in 2020 will be able to do it.
Title: Re: How long can we wait while flattening the curve?
Post by: Boofinator on March 20, 2020, 10:33:46 AM
@waltworks I'd be shocked if we last more than a month.  At some point, businesses are going to open their doors rather than go out of business.  Parents are going to insist that schools reopen, because they need to go to work and they need some relief from childcare.

I read an interesting piece in the NYT by an historian of the 1918 flu.  The part that stuck out to me was that even the army, in wartime, wasn't able to maintain effective quarantines for long enough to matter all that much.  We as humans just aren't wired for extended periods of isolation.  If a wartime army a hundred years ago couldn't do it, I highly doubt ordinary Americans in 2020 will be able to do it.

As others have noted, there are major differences between 1918 and today.


I think the big question that remains to be answered is how far ahead of the pandemic were we able to get in the U.S. If things turn out that people are dying in the streets, businesses will remain closed for the foreseeable future, as people will be overly cautious. On the other hand, if we're able to contain it so that healthcare workers can manage the workload, we will get a false sense of security and there might be a push to end quarantine measures prematurely.
Title: Re: How long can we wait while flattening the curve?
Post by: Cassie on March 20, 2020, 11:53:21 AM
Nevada is shutdown. We are very tourist dependent but it’s the right move. My kids will most likely have to move in with us. We are retired on small pensions so as a family will be fine.  We will do what families did during the depression. Families live together and make it work. For those without families it will be hell.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on March 20, 2020, 05:01:34 PM
Nevada is shutdown. We are very tourist dependent but it’s the right move. My kids will most likely have to move in with us. We are retired on small pensions so as a family will be fine.  We will do what families did during the depression. Families live together and make it work. For those without families it will be hell.
Yup. Kids *are* social security. As are parents.
Title: Re: How long can we wait while flattening the curve?
Post by: Travis on March 20, 2020, 05:46:23 PM
@waltworks I'd be shocked if we last more than a month.  At some point, businesses are going to open their doors rather than go out of business.  Parents are going to insist that schools reopen, because they need to go to work and they need some relief from childcare.

I read an interesting piece in the NYT by an historian of the 1918 flu.  The part that stuck out to me was that even the army, in wartime, wasn't able to maintain effective quarantines for long enough to matter all that much.  We as humans just aren't wired for extended periods of isolation.  If a wartime army a hundred years ago couldn't do it, I highly doubt ordinary Americans in 2020 will be able to do it.

There's some evidence (but nothing conclusive) that the 1918 flu started in a US Army camp and we brought it over to Europe. With millions of soldiers huddled in trenches and slugging it out, quarantine just wasn't an option.

On the flip side, the modern US military community is in a great position to force isolation.  Our bases have controlled access, we can be legally restricted from going to certain places, and being federal employees we're salaried.  I live just off base, but I get screened now every time I go through the gate. I was given specific orders that if I feel flu-like symptoms to stay away and call the hospital for instructions.  Having all of our plans upended and being told to sit and wait is something we get a lot of practice at.
Title: Re: How long can we wait while flattening the curve?
Post by: mm1970 on March 20, 2020, 06:06:09 PM
My state had no countermeasures until 2 weeks ago, even now we are far from total lockdown. Cases in the state have gone from 1 to 1370 (probably many more untested). I don't know what rate of growth that is but it is way less than the 90% infection rate cited in the original scenario I responded to.

watch what is happening to the italians. their numbers should be reliable. in about a week, the state may reach 5000+ cases if the infection rate is similar to italy.

https://www.reddit.com/r/dataisbeautiful/comments/fhykic/oc_this_chart_comparing_infection_rates_between/

I do not think we will see that growth in the US because there literally are not tests. So they are hoarding tests just like toilet paper.

If you aren't admitted to the hospital or a celebrity or healthcare worker, no test.
Yeah, my BFF bailed on our walk last week because her kid woke up sick.  It was pouring anyway.  In the last week, she, both her twins, and her older child (all kids in elementary) have been down HARD with fever/ cough.  Could be regular flu?  She's not able to be upright for more than 30 min at a time.  Husband still going to work.

But they aren't testing her because she's under 50.  I have a running friend who also has all the signs, but they aren't testing her either.

Literally not testing anyone if you haven't been traveling, haven't been around a known case, or are under 50.
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 20, 2020, 10:36:05 PM
This was a really good article about what lies on the other side of the lockdowns and why a hard lockdown is a preferable strategy to a half-assed flattening of the curve: https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56 (https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56).
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 21, 2020, 09:31:08 AM
The pushback is already beginning from within public health: https://www.nytimes.com/2020/03/20/opinion/coronavirus-pandemic-social-distancing.html?action=click&module=Opinion&pgtype=Homepage

Quote
Such is the collateral damage of this diffuse form of warfare, aimed at “flattening” the epidemic curve generally rather than preferentially protecting the especially vulnerable. I believe we may be ineffectively fighting the contagion even as we are causing economic collapse.

There is another and much overlooked liability in this approach. If we succeed in slowing the spread of coronavirus from torrent to trickle, then when does the society-wide disruption end? When will it be safe for healthy children and younger teachers to return to school, much less older teachers and teachers with chronic illnesses? When will it be safe for the work force to repopulate the workplace, given that some are in the at-risk group for severe infection?

Basically, we don't even know how well social distancing will work, but we can see that we're causing very real damage to real people's lives by doing it.  And, it's worth noting, that the people most likely to be economically harmed are the young and less well off working on the lower rungs of the service industries.
Title: Re: How long can we wait while flattening the curve?
Post by: markus on March 21, 2020, 09:51:41 AM
Quote
This was a really good article about what lies on the other side of the lockdowns and why a hard lockdown is a preferable strategy to a half-assed flattening of the curve: https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56.

Seconding this. I find Mr. Pueyo's article particularly convincing, and I personally would prefer this much stricter approach in the short term over the significant but still loose approach currently in place. With a virus so contagious and nefarious in its method of operation (i.e. high transmission from asymptomatic individuals), it's likely going to be the only way to get control of the situation.

Picture a field of dry grass and someone lighting small fires everywhere, except you can't see the flames until they grow to a certain height. To quote the immortal Barney Fife, we gotta, "Nip it in the bud!"
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 21, 2020, 09:47:26 PM
Quote
This was a really good article about what lies on the other side of the lockdowns and why a hard lockdown is a preferable strategy to a half-assed flattening of the curve: https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56.

Seconding this. I find Mr. Pueyo's article particularly convincing, and I personally would prefer this much stricter approach in the short term over the significant but still loose approach currently in place. With a virus so contagious and nefarious in its method of operation (i.e. high transmission from asymptomatic individuals), it's likely going to be the only way to get control of the situation.

Picture a field of dry grass and someone lighting small fires everywhere, except you can't see the flames until they grow to a certain height. To quote the immortal Barney Fife, we gotta, "Nip it in the bud!"

The evidence is beginning to point towards low transmission between asymptomatic individuals.
Title: Re: How long can we wait while flattening the curve?
Post by: Fru-Gal on March 22, 2020, 01:23:00 AM
The other good point made in the article is that the virus is mutating all over the world. So if we think we're all gonna catch it and be immune, we may be horribly wrong. Whereas if we work HARD to stop it now (the hammer approach) we could stamp it out.
Title: Re: How long can we wait while flattening the curve?
Post by: Jon Bon on March 22, 2020, 10:28:40 AM
Quote
This was a really good article about what lies on the other side of the lockdowns and why a hard lockdown is a preferable strategy to a half-assed flattening of the curve: https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56.

Seconding this. I find Mr. Pueyo's article particularly convincing, and I personally would prefer this much stricter approach in the short term over the significant but still loose approach currently in place. With a virus so contagious and nefarious in its method of operation (i.e. high transmission from asymptomatic individuals), it's likely going to be the only way to get control of the situation.

Picture a field of dry grass and someone lighting small fires everywhere, except you can't see the flames until they grow to a certain height. To quote the immortal Barney Fife, we gotta, "Nip it in the bud!"

The evidence is beginning to point towards low transmission between asymptomatic individuals.

@ReadySetMillionaire

Can you give a source on this? Sure would be nice if that is true!

Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 22, 2020, 11:22:18 AM
The other good point made in the article is that the virus is mutating all over the world. So if we think we're all gonna catch it and be immune, we may be horribly wrong. Whereas if we work HARD to stop it now (the hammer approach) we could stamp it out.
I think that's more of a scare tactic this at this point.  Mutations are normal, and I heard the mutations still left the different strains so identical that a vaccine or immunity against one would be extremely likely to provide protection against the other.
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 22, 2020, 08:08:20 PM
Really good NYT article today (https://www.nytimes.com/2020/03/22/health/coronavirus-restrictions-us.html) surveying a bunch of experts and they basically advocate the "hammer" approach:

Quote
... The next priority, experts said, is extreme social distancing.

If it were possible to wave a magic wand and make all Americans freeze in place for 14 days while sitting six feet apart, epidemiologists say, the whole epidemic would sputter to a halt. The virus would die out on every contaminated surface and, because almost everyone shows symptoms within two weeks, it would be evident who was infected. If we had enough tests for every American, even the completely asymptomatic cases could be found and isolated.

The crisis would be over.

Obviously, there is no magic wand, and no 300 million tests. But the goal of lockdowns and social distancing is to approximate such a total freeze.

Quote
... It’s an intimidating picture. But the weaker the freeze, the more people die in overburdened hospitals — and the longer it ultimately takes for the economy to restart.

That's the second priority. Their first is:

Quote
Many experts, some of whom are international civil servants, declined to speak on the record for fear of offending the president. But they were united in the opinion that politicians must step aside and let scientists both lead the effort to contain the virus and explain to Americans what must be done.

Just as generals take the lead in giving daily briefings in wartime — as Gen. Norman Schwarzkopf did during the Persian Gulf war — medical experts should be at the microphone now ...
I find it extremely alarming that people are afraid to speak freely about what should be done because of Trump. I have no confidence that if it comes down to agreeing with an aggressive course of action or doubling down on what he's said before that it won't be that bad, because he's clinically unable to admit he's wrong, he won't send people to their deaths...
Title: Re: How long can we wait while flattening the curve?
Post by: fattest_foot on March 22, 2020, 09:47:06 PM
The problem is, their only concern is the virus. Economy be damned.

And while yes, that may end up squashing the virus (for this season anyway), and we'll save the healthcare industry...what about the dozens of other industries that seize up to save the one?

What about the people that die in the oncoming depression? Are their lives less valuable than those saved from the virus?
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 22, 2020, 10:48:15 PM
The problem is, their only concern is the virus. Economy be damned.
Did you even read the article?
Quote
the weaker the freeze, the more people die in overburdened hospitals — and the longer it ultimately takes for the economy to restart.
Title: Re: How long can we wait while flattening the curve?
Post by: Ratherboard on March 22, 2020, 10:54:33 PM
I've been watching this site for following the "flattening of the curve"   https://coronavirus.1point3acres.com/en

I agree with some who have stated that with more testing, we will have more data. Then know who to quarantine and slow down the death rate and spread rate.  Quite simply, test, test, and test.  As of today, the US has completed 254,000 tests, which initially sounds impressive.  However, out of approximately 354 million people in the US, that's not a lot. 
Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on March 23, 2020, 06:02:42 AM
if the US had leadership, there'd be a 3 week hard shutdown, everywhere. only essential services would somehow operate.

you can't piecemeal this stuff.

borders and all flight would need to be locked down.

as it stands now, i think states that are shelter-in-place would be wise to lock down their borders with adjoining states without the same policy.

once food rations and other consumables start running out, prepare for violence, at least in this country. i am not optimistic.
Title: Re: How long can we wait while flattening the curve?
Post by: Radagast on March 23, 2020, 10:51:51 AM
if the US had leadership, there'd be a 3 week hard shutdown, everywhere. only essential services would somehow operate.

you can't piecemeal this stuff.

borders and all flight would need to be locked down.
I agree. Some time like right now, plus or minus a few days, "someone" who claims/wants to claim leadership over the country needs to declare that all movement of people must stop for 2-4 weeks except as critical to life. On the course we are on the economic activity of most places will be locked down for months, while the infection still spreads unchecked. The worst of both outcomes. The opposite of leadership.

The pandemic ended in China within a few weeks. I don't think people understand the extent of the Chinese lockdowns, and I don't just mean the extreme version in Wuhan. Every village in the country blockaded its roads with bricks and sticks and chicks (made for funny images on Chinese social media) and refused to let anything that was not vital in or out for two months. All non-vital traffic between cities and provinces ended. Now they are going back to normal. Lesson?

Quote
once food rations and other consumables start running out, prepare for violence, at least in this country. i am not optimistic.
Ok, you are freaking out. Quite the opposite: there will be an overabundance of most consumables, food supply will be at the same rate it has always been (but with more going to groceries and take out), and it will be oddly calm.

Maybe step away from the internet for a few days. Watch a funny movie. Exercise. Play some video games. Everything will work out alright, and I am serious when I say that.
Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on March 23, 2020, 11:53:07 AM
Ok, you are freaking out. Quite the opposite: there will be an overabundance of most consumables, food supply will be at the same rate it has always been (but with more going to groceries and take out), and it will be oddly calm.

Maybe step away from the internet for a few days. Watch a funny movie. Exercise. Play some video games. Everything will work out alright, and I am serious when I say that.
have you seen black friday deals videos?
we're talking about having food to eat.
most americans have barely enough $ to get them to the next week.
stay calm and rational. ok.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 23, 2020, 12:13:51 PM

Quote
once food rations and other consumables start running out, prepare for violence, at least in this country. i am not optimistic.
Ok, you are freaking out. Quite the opposite: there will be an overabundance of most consumables, food supply will be at the same rate it has always been (but with more going to groceries and take out), and it will be oddly calm.

Maybe step away from the internet for a few days. Watch a funny movie. Exercise. Play some video games. Everything will work out alright, and I am serious when I say that.

My open question is how food supply might be disrupted by a lack of workers. Sure, the end of the supply chain (grocery stores) is working, but there are gaps in the middle.  Cows, Chickens and Pigs are still going to produce meat, milk and butter.  Farms (AFAIK) are still growing food just fine.  But we've had a shortage of migrant workers last year, and now we've effectively closed off that entire labor-force with the border closures.  Food doesn't just go from the field to the grocery store - it gets picked or slaughtered, cleaned, stored, transported, re-packaged, transported again and then sent to individual grocery stores.
A lot of produce comes from Chile and Mexico right now. 

Some stuff we already have in warehouses in multi-month supplies (e.g. apples, potatoes, many canned/frozen products).  But the more perishable stuff ... that's more vulnerable to disruptions in teh supply chain.

My personal take is that we'll have plenty of food for a long while, but we're going to rapidly see widespread shortages of fresh/perishable stuff, as well as some random other stuff.  There will be plenty to feed anyone who has a normal amount of grocery money, but not everything you want will always be aailable (as we've become accustomed to here in the western world).
Title: Re: How long can we wait while flattening the curve?
Post by: Luz on March 23, 2020, 01:12:33 PM
if the US had leadership, there'd be a 3 week hard shutdown, everywhere. only essential services would somehow operate.

you can't piecemeal this stuff.

borders and all flight would need to be locked down.
I agree. Some time like right now, plus or minus a few days, "someone" who claims/wants to claim leadership over the country needs to declare that all movement of people must stop for 2-4 weeks except as critical to life. On the course we are on the economic activity of most places will be locked down for months, while the infection still spreads unchecked. The worst of both outcomes. The opposite of leadership.

The pandemic ended in China within a few weeks. I don't think people understand the extent of the Chinese lockdowns, and I don't just mean the extreme version in Wuhan. Every village in the country blockaded its roads with bricks and sticks and chicks (made for funny images on Chinese social media) and refused to let anything that was not vital in or out for two months. All non-vital traffic between cities and provinces ended. Now they are going back to normal. Lesson?

Quote
once food rations and other consumables start running out, prepare for violence, at least in this country. i am not optimistic.
Ok, you are freaking out. Quite the opposite: there will be an overabundance of most consumables, food supply will be at the same rate it has always been (but with more going to groceries and take out), and it will be oddly calm.

Maybe step away from the internet for a few days. Watch a funny movie. Exercise. Play some video games. Everything will work out alright, and I am serious when I say that.

But how will the people who don't have remote jobs or savings pay for those consumables? This country has a high rate of inequality (the highest it's been in 50 years, per the Census), which will likely greatly exacerbate the issue.
Title: Re: How long can we wait while flattening the curve?
Post by: Radagast on March 23, 2020, 02:43:39 PM
In general I cannot see any reason why the food supply chain will substantially change. It will switch more to cook at home choices, which are also less expensive so people's money will go farther.

I am not concerned about labor to harvest food. There is plenty of food, and all of the people still need it. Collectively we will make it work, even if vegetable prices rise to pay agricultural workers decent wages, or we have to actually think of a reasonable immigration solution.

I guess that non essential consumables will not sell well for the next year, which is why there will be an overabundance. I am sure some people will have financial stress. Many people will donate, including me if I start reading of problems in the local news. Charity kitchens are all open. The government is sending people unemployment money and soon checks. Financial inequality is too extreme, but it's not like everybody is helpless. People have resources.
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 23, 2020, 03:30:50 PM
Trump is chomping at the bit to end the quarantines and social distancing because it's hurting his economic numbers and chance of re-election.  Just more proof that he doesn't really care about American lives and overwhelmed hospitals.   It's all about him.

https://www.cnn.com/2020/03/23/politics/trump-coronavirus-15-days-social-distancing/index.html
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 23, 2020, 03:39:59 PM
I dislike Trump strongly too, but his point "the cure can't be worse than the disease" (paraphrasing) is true.

Are we willing to spend many trillions of dollars and collapse our economy to (maybe) save something like a million mostly elderly people?

I don't have an answer for that, but based on how we value human life in other situations with limited resources, the answer is probably "no" from a utilitarian perspective.

There's enough uncertainty about the costs on both sides of the equation that it's not cut and dried, though. The economic damage might be much greater and the lives saved less, or the economic damage might be minimal/business as usual soon and the risk to life far greater.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on March 23, 2020, 03:43:55 PM
from day 1, like december, i have believed it either needs to be full shutdown (way way too late for that) or let it run wild and a lot of people emotionally suffer bigly. we're in the middle. it's too late. trump is correct in this case (probably not very well thought through on his part, but still)
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 23, 2020, 06:34:03 PM
from day 1, like december, i have believed it either needs to be full shutdown (way way too late for that) or let it run wild and a lot of people emotionally suffer bigly. we're in the middle. it's too late. trump is correct in this case (probably not very well thought through on his part, but still)
It is never too late for a full shutdown. No one moves, it burns out in one cycle. Then you go the South Korea and aggressively track and contain the cases that pop up.

In fact, once the corpses start piling up, things will shutdown by themselves. I don't understand those that think we can just have the "economy" go back to normal while a million people are dying. Do you really think people will be willing to just go about their business and risk getting infected when the hospitals have broken down and people are dying in droves?
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 23, 2020, 06:43:25 PM
Are we willing to spend many trillions of dollars and collapse our economy to (maybe) save something like a million mostly elderly people?

Some of those people who will die will be healthcare professionals. If the hospitals are overrun there will be MDs and RNs with PTSD and the ones that have the resources to retire early will. People are already talking about a major healthcare professional shortage a year from now.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 23, 2020, 06:44:58 PM
Trump is chomping at the bit to end the quarantines and social distancing because it's hurting his economic numbers and chance of re-election.  Just more proof that he doesn't really care about American lives and overwhelmed hospitals.   It's all about him.

https://www.cnn.com/2020/03/23/politics/trump-coronavirus-15-days-social-distancing/index.html

Or his complete lack of attention span. We've quantified his attention span: 15 days.
Title: Re: How long can we wait while flattening the curve?
Post by: Telecaster on March 23, 2020, 07:09:32 PM
I dislike Trump strongly too, but his point "the cure can't be worse than the disease" (paraphrasing) is true.

Are we willing to spend many trillions of dollars and collapse our economy to (maybe) save something like a million mostly elderly people?

I don't have an answer for that, but based on how we value human life in other situations with limited resources, the answer is probably "no" from a utilitarian perspective.

There's enough uncertainty about the costs on both sides of the equation that it's not cut and dried, though. The economic damage might be much greater and the lives saved less, or the economic damage might be minimal/business as usual soon and the risk to life far greater.

-W

That's the thing.  We don't really know.  FWIW, CDC reports something like 30% of hospitalizations are people under 65 (approx. number).   There is a wide range of estimates of how many might get infected with no mitigation, ranging from many tens to hundreds of millions.  If even a small percentage of those require hospitalization, we would completely wipe out all of our health care capacity in this country, which would cause many needless deaths not only among COVID patients, but among the rest of the population too.   

Then we have however many people too sick too work.  There's a cost there.  And many people survive COVID with permanent disabilities.  There's a cost there, too.



Title: Re: How long can we wait while flattening the curve?
Post by: fattest_foot on March 23, 2020, 07:22:56 PM
Trump is chomping at the bit to end the quarantines and social distancing because it's hurting his economic numbers and chance of re-election.  Just more proof that he doesn't really care about American lives and overwhelmed hospitals.   It's all about him.

https://www.cnn.com/2020/03/23/politics/trump-coronavirus-15-days-social-distancing/index.html

Your partisanship is showing. Why is it "his" economy and not "our" economy? Are you not participating in it?
Title: Re: How long can we wait while flattening the curve?
Post by: Telecaster on March 23, 2020, 07:27:42 PM
Trump is chomping at the bit to end the quarantines and social distancing because it's hurting his economic numbers and chance of re-election.  Just more proof that he doesn't really care about American lives and overwhelmed hospitals.   It's all about him.

https://www.cnn.com/2020/03/23/politics/trump-coronavirus-15-days-social-distancing/index.html

Your partisanship is showing. Why is it "his" economy and not "our" economy? Are you not participating in it?

Trump often references the economy and stock markets as personal achievements.  I interpreted @American GenX 's comment to mean how Trump views the economy, not how American GenX does. 
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on March 23, 2020, 07:36:11 PM
Trump is chomping at the bit to end the quarantines and social distancing because it's hurting his economic numbers and chance of re-election.  Just more proof that he doesn't really care about American lives and overwhelmed hospitals.   It's all about him.

https://www.cnn.com/2020/03/23/politics/trump-coronavirus-15-days-social-distancing/index.html

Your partisanship is showing. Why is it "his" economy and not "our" economy? Are you not participating in it?

Trump often references the economy and stock markets as personal achievements.  I interpreted @American GenX 's comment to mean how Trump views the economy, not how American GenX does.

That was how I interpreted it. Trump views national achievements as his personal successes, and national failures as the fault of anyone but himself.
Title: Re: How long can we wait while flattening the curve?
Post by: martyconlonontherun on March 23, 2020, 08:56:16 PM
I dislike Trump strongly too, but his point "the cure can't be worse than the disease" (paraphrasing) is true.

Are we willing to spend many trillions of dollars and collapse our economy to (maybe) save something like a million mostly elderly people?

I don't have an answer for that, but based on how we value human life in other situations with limited resources, the answer is probably "no" from a utilitarian perspective.

There's enough uncertainty about the costs on both sides of the equation that it's not cut and dried, though. The economic damage might be much greater and the lives saved less, or the economic damage might be minimal/business as usual soon and the risk to life far greater.

-W
Yes. Selfishly my first kid is due in early May. I'm scared to death something goes wrong and the NICU is overwhelmed. I'm already the only person allowed with my wife in the hospital. If things get worse I'll miss that. This isn't just about worthless old people if that is your mindset. It impacts everyone.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 23, 2020, 09:44:04 PM
Lots of babies will die if there's a complete collapse of the economy, too, though. I mean, they'll mostly be poor people's babies, not yours. But still.

I don't hate old people or babies. Yet I drive a car sometimes, which means there's some small chance I'll kill or hurt one. As a society, we've decided it's ok to kill thousands of people a year for the convenience of personal automobiles. Literally for the sake of laziness and convenience - we could all be taking the bus/riding bikes/walking.

See where I'm going with this? Life has a value, even if it feels a bit icky to think about it.

Again, I don't personally know whether the current lockdowns and economic damage are worth it or not, and I'm not saying we should just immediately resume normal life and let people die. But we shouldn't accept any amount of economic harm, no matter how great, to save limited lives, either.

My feeling is that the half-assed lockdowns and limited enforcement I've witnessed thus far are the worst of both worlds.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 23, 2020, 10:19:11 PM
Lots of babies will die if there's a complete collapse of the economy, too, though. I mean, they'll mostly be poor people's babies, not yours. But still.

Do you have any data to back up this claim? Is there some example of an economic collapse in a developed western country leading to "lots of babies" dying?
Title: Re: How long can we wait while flattening the curve?
Post by: Roland of Gilead on March 23, 2020, 10:40:44 PM
Lots of babies will die if there's a complete collapse of the economy, too, though. I mean, they'll mostly be poor people's babies, not yours. But still.

Do you have any data to back up this claim? Is there some example of an economic collapse in a developed western country leading to "lots of babies" dying?

I don't think we have actually had a complete collapse of a modern developed country in recent history.   It is not unrealistic to think many people would die, not just babies, if we had a complete collapse.
Title: Re: How long can we wait while flattening the curve?
Post by: Cassie on March 23, 2020, 10:43:46 PM
Babies will have priority as they should. My generation had babies without husbands in the delivery room and my mom’s had them without them in the labor room. It sucks but is survival.  Old people like me will be sacrificed and I am okay with that if we have a shutdown and don’t reopen in 8 days. 
Title: Re: How long can we wait while flattening the curve?
Post by: Sultan58 on March 23, 2020, 11:25:44 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.

I think you are not taking into account that Hubei was put on a central party  lockdown that is much more stringent that the UK or the US would ever be able to mandate. That's why their numbers were relatively low.
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on March 24, 2020, 03:44:16 AM
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.

I think you are not taking into account that Hubei was put on a central party  lockdown that is much more stringent that the UK or the US would ever be able to mandate. That's why their numbers were relatively low.

It took over two months for them to implement that lockdown though. The first reported case of what is now known as COVID-19 was reported to the Chinese gov on 11-19-2019:
https://www.livescience.com/first-case-coronavirus-found.html

Wuhan was locked down 1-23-2020. There are 58.5 million people in Hubei, which is very similar in land area to Washington state. For reference, California is the most populous state in the US with 37 million people and more than twice the land area of Hubei. So Hubei is very densely populated. Hubei also has pretty poor air quality. So in Hubei, they gave a new respiratory virus a 2 month head start in what's basically an ideal breeding ground (dense population, poor air quality, travel and manufacturing hub generates tons of movement among citizens).

If you'd like to consider other locations than China, lets look at the latest situation report from the WHO:

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

Italy has 59138 confirmed cases among a population of 60.5 million ~ 0.097% of the total population
Spain has 28572 cases among 46.6 million ~ 0.06% of the total population
Germany has 27774 cases among 82.8 million ~ 0.033% of the total population
The UK has 5687 cases among 66.4 million ~ 0.0085% of the total population
Iran has 21638 cases among 81.1 million ~ 0.026% of the total population
US has 31573 cases among 327 million ~ 0.0096% of the total population

And keep in mind that those numbers show the number of confirmed cases. Only a relatively small percentage of those confirmed cases result in deaths. I understand that testing isn't being done on a large number of people, and that there are guaranteed to be many people with minor symptoms that haven't been tested and therefore aren't showing up in this data. That's probably true for every country on Earth.
That means that a larger percentage of the total population than what is shown likely has COVID-19, but it also means that the mortality rate is lower than what's been calculated with the current data as well.You can't add a bunch of people with minor symptoms (or no symptoms at all) to the data set without reducing the mortality rate by a decent margin. In other words, the virus is more widespread than the data reflects, but it's also less deadly than the data reflects too.

Title: Re: How long can we wait while flattening the curve?
Post by: partgypsy on March 24, 2020, 05:58:14 AM
I dislike Trump strongly too, but his point "the cure can't be worse than the disease" (paraphrasing) is true.

Are we willing to spend many trillions of dollars and collapse our economy to (maybe) save something like a million mostly elderly people?

I don't have an answer for that, but based on how we value human life in other situations with limited resources, the answer is probably "no" from a utilitarian perspective.

There's enough uncertainty about the costs on both sides of the equation that it's not cut and dried, though. The economic damage might be much greater and the lives saved less, or the economic damage might be minimal/business as usual soon and the risk to life far greater.

-W
Yes. Selfishly my first kid is due in early May. I'm scared to death something goes wrong and the NICU is overwhelmed. I'm already the only person allowed with my wife in the hospital. If things get worse I'll miss that. This isn't just about worthless old people if that is your mindset. It impacts everyone.
I don't want to scare you, but women in their third trimester have suppressed immune systems. They are posited to have higher risk of dying from Corona. If she could do a home birth; may be preferable.  Also those who are talking about relative occurrence and death rates. The main takeaway this is a novel virus that we have no natural defense from. We know the mortality rate is not .1%, because that is the mortality rate of flu and with flu we do not get these hot spots and overloading of hospital systems. And whether it is. .5 or 2% it is an exponential growth, and exponential growth does not look too bad till it explodes.   I also prefer a fuller lock down. I don't know if there is political will and understanding for that to happen.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 24, 2020, 07:01:22 AM
I am the author of a thread on here ripping Trump, and I stand by everything I said (that he botched this horribly in Jan/Feb/early March).

But, I saw this article on Medium yesterday, apparently written by an accountant in Canton advocating for the opening of Ohio's economy, and it has at least shifted my opinion.

https://medium.com/@adam_61330/an-open-letter-to-governor-mike-dewine-trust-ohioans-to-open-up-business-on-april-6-4eb0add31df5

The author states that for every one C-19 death in Ohio, there have been 23,245 claims for unemployment, and that was only claims for last Monday through Thursday.  I know for a fact it's way worse than that.  The economic catastrophe is just staggering to me.

Regarding research, the author cites an interesting paper from Duke that I was bored enough to read in its entirety (mostly to try and calm myself about this disease).  The authors basically conclude that this virus cannot spread "exponentially" because society works in closed networks: https://www.medrxiv.org/content/10.1101/2020.02.16.20023820v2.full.pdf

I totally understand that public health is remarkably important, and that balancing public health and the economy is an almost impossible choice, but I am starting to turn towards the economy NEEDING to open ASAP.  And I really mean ASAP by it's literal definition -- as soon as possible.

What's as soon as possible? When we have enough capacity to test, isolate, treat, and manufacture PPE/ventilators.  I don't have the answer to that quiz, but we need to be focusing on this issue with a borderline military industrial complex.

This economic story is a catastrophe that will make the 2008 Recession seem impotent.  It's a wasteland out there, and there will be enormous public health consequences from that that we have to consider.
Title: Re: How long can we wait while flattening the curve?
Post by: dougules on March 24, 2020, 08:00:49 AM
I see everyone making the assumption that the economic benefits of ending restrictions will outweight the costs of letting the virus spread.  What is the cost of so many people being out of work for weeks from getting sick, even if they aren't critically ill?  Are people really going to go back to eating out, traveling, and shopping as normal once the virus is everywhere?  Also, the US economy really hinges on trade with other countries.  Are countries that have made extreme sacrifices to fight the spread going to let potentially infected Americans travel and do business freely?  There will be severe economic pain either way.  It's not so clear-cut that sending everyone back to work will do enough good to outweigh sacrificing so many people.   
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on March 24, 2020, 08:07:48 AM
I heard a quote recently, didn't note who said it but it wasn't me: ultimately you need a life to have a livelihood.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 24, 2020, 08:09:56 AM
I see everyone making the assumption that the economic benefits of ending restrictions will outweight the costs of letting the virus spread.  What is the cost of so many people being out of work for weeks from getting sick, even if they aren't critically ill?  Are people really going to go back to eating out, traveling, and shopping as normal once the virus is everywhere?  Also, the US economy really hinges on trade with other countries.  Are countries that have made extreme sacrifices to fight the spread going to let potentially infected Americans travel and do business freely?  There will be severe economic pain either way.  It's not so clear-cut that sending everyone back to work will do enough good to outweigh sacrificing so many people.

I think the data we are relying on to make these projections has thus far been proven to be fucking terrible, drastically over-estimated, and based upon assumptions that have proven not to be true.
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on March 24, 2020, 08:43:18 AM
I see everyone making the assumption that the economic benefits of ending restrictions will outweight the costs of letting the virus spread.  What is the cost of so many people being out of work for weeks from getting sick, even if they aren't critically ill?  Are people really going to go back to eating out, traveling, and shopping as normal once the virus is everywhere?  Also, the US economy really hinges on trade with other countries.  Are countries that have made extreme sacrifices to fight the spread going to let potentially infected Americans travel and do business freely?  There will be severe economic pain either way.  It's not so clear-cut that sending everyone back to work will do enough good to outweigh sacrificing so many people.

Well right now, we're pretty much guaranteeing that most people are missing work aren't we? And it's all at the same time? There's basically zero commerce taking place on the entire planet outside of groceries. Even if 10-20% of the workforce were missing a couple of weeks at a time while sick, the remainder can keep some production going. Commerce still occurs during flu season ( I know this is more extreme than the flu, just saying).
Title: Re: How long can we wait while flattening the curve?
Post by: dougules on March 24, 2020, 11:04:27 AM
I see everyone making the assumption that the economic benefits of ending restrictions will outweight the costs of letting the virus spread.  What is the cost of so many people being out of work for weeks from getting sick, even if they aren't critically ill?  Are people really going to go back to eating out, traveling, and shopping as normal once the virus is everywhere?  Also, the US economy really hinges on trade with other countries.  Are countries that have made extreme sacrifices to fight the spread going to let potentially infected Americans travel and do business freely?  There will be severe economic pain either way.  It's not so clear-cut that sending everyone back to work will do enough good to outweigh sacrificing so many people.

I think the data we are relying on to make these projections has thus far been proven to be fucking terrible, drastically over-estimated, and based upon assumptions that have proven not to be true.

The lack of good data cuts both ways.  Does it make sense to try and return to normal before we have enough test kits to get a clear picture of what is happening?
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 24, 2020, 11:21:53 AM
Lots of babies will die if there's a complete collapse of the economy, too, though. I mean, they'll mostly be poor people's babies, not yours. But still.

Do you have any data to back up this claim? Is there some example of an economic collapse in a developed western country leading to "lots of babies" dying?

I don't think we have actually had a complete collapse of a modern developed country in recent history.   It is not unrealistic to think many people would die, not just babies, if we had a complete collapse.

waltworks said a complete (intentional) collapse of the economy, not a complete collapse of the country. Again, I'm not worried, and no one can point to to a scary counter-example.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 24, 2020, 12:36:40 PM
I see everyone making the assumption that the economic benefits of ending restrictions will outweight the costs of letting the virus spread.  What is the cost of so many people being out of work for weeks from getting sick, even if they aren't critically ill?  Are people really going to go back to eating out, traveling, and shopping as normal once the virus is everywhere?  Also, the US economy really hinges on trade with other countries.  Are countries that have made extreme sacrifices to fight the spread going to let potentially infected Americans travel and do business freely?  There will be severe economic pain either way.  It's not so clear-cut that sending everyone back to work will do enough good to outweigh sacrificing so many people.

Well right now, we're pretty much guaranteeing that most people are missing work aren't we? And it's all at the same time? There's basically zero commerce taking place on the entire planet outside of groceries. Even if 10-20% of the workforce were missing a couple of weeks at a time while sick, the remainder can keep some production going. Commerce still occurs during flu season ( I know this is more extreme than the flu, just saying).

zero commerce? not even close to true.
Title: Re: How long can we wait while flattening the curve?
Post by: itchyfeet on March 24, 2020, 12:57:58 PM
Yep, completely not true.

Sure groceries continues, but so does utilities, banking, home maintenance, cleaning, freight transport, mining.... I could list so many industries.

DW went to a book store yesterday to buy a puzzle and the store keeper apologised because there had been a massive run on puzzles. They received additional stock that morning and by evening they were gone.

Everywhere you look you can see commerce.
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on March 24, 2020, 01:12:30 PM
Amazon is exploding with business right now.
Title: Re: How long can we wait while flattening the curve?
Post by: Luz on March 24, 2020, 01:49:44 PM
I heard a quote recently, didn't note who said it but it wasn't me: ultimately you need a life to have a livelihood.

But by definition, livelihood is "a means of supporting one's existence". The economic and health crises can't be separated from each other. They are interrelated. It's not an either/or choice.
Title: Re: How long can we wait while flattening the curve?
Post by: Luz on March 24, 2020, 02:08:53 PM
I dislike Trump strongly too, but his point "the cure can't be worse than the disease" (paraphrasing) is true.

Are we willing to spend many trillions of dollars and collapse our economy to (maybe) save something like a million mostly elderly people?

I don't have an answer for that, but based on how we value human life in other situations with limited resources, the answer is probably "no" from a utilitarian perspective.

There's enough uncertainty about the costs on both sides of the equation that it's not cut and dried, though. The economic damage might be much greater and the lives saved less, or the economic damage might be minimal/business as usual soon and the risk to life far greater.

-W
Yes. Selfishly my first kid is due in early May. I'm scared to death something goes wrong and the NICU is overwhelmed. I'm already the only person allowed with my wife in the hospital. If things get worse I'll miss that. This isn't just about worthless old people if that is your mindset. It impacts everyone.
I don't want to scare you, but women in their third trimester have suppressed immune systems. They are posited to have higher risk of dying from Corona. If she could do a home birth; may be preferable.  Also those who are talking about relative occurrence and death rates. The main takeaway this is a novel virus that we have no natural defense from. We know the mortality rate is not .1%, because that is the mortality rate of flu and with flu we do not get these hot spots and overloading of hospital systems. And whether it is. .5 or 2% it is an exponential growth, and exponential growth does not look too bad till it explodes.   I also prefer a fuller lock down. I don't know if there is political will and understanding for that to happen.

From what they currently know, women who became ill with the virus in their third trimester (complete with pneumonia) had outcomes consistent with lower-risk groups.
https://www.npr.org/sections/health-shots/2020/03/22/817801475/pregnant-and-worried-about-coronavirus-how-to-stay-safe-and-make-a-game-plan
"None of the women developed severe illness, and all of their babies were born healthy."
It's based on a small sample size, but I find it reassuring that pregnant women and children under 5 do not appear to be vulnerable populations (as is the usual case).
Title: Re: How long can we wait while flattening the curve?
Post by: Jon Bon on March 24, 2020, 02:15:56 PM
Yep, completely not true.

Sure groceries continues, but so does utilities, banking, home maintenance, cleaning, freight transport, mining.... I could list so many industries.

DW went to a book store yesterday to buy a puzzle and the store keeper apologised because there had been a massive run on puzzles. They received additional stock that morning and by evening they were gone.

Everywhere you look you can see commerce.

I think that might have been a bit of hyperbole.

However the point remains you simply cannot surgically cut out 50% (or 25%, 10% etc) of the economy and expect the remainder to run long on its own.

If we can't restart in April I think we are going to have a hard time restarting at all. How long are we willing to wait? How bad of a depression are we willing to stand on the side of safety?

Remember folks almost all of us on here are in most measurements freaking rich! So that has to cloud our judgement some. Sure we will likely be fine, but we are a tiny subset of the world as a whole. Lots of people simply cannot miss a week of work and stay afloat. Even more cant miss a month, let alone 2-3.

We need everyone to make the economy work, savers/spenders, rich and poor. Lets all stay home now, but we gotta get back out there sooner rather than later.



 
Title: Re: How long can we wait while flattening the curve?
Post by: Jon Bon on March 24, 2020, 02:23:24 PM
So lets do some math shall we? This is what I got about what this is costing us.

GDP    20,000,000,000,000
Daily GDP    54,794,520,548
US population    327,000,000
Daily GDP Per Person    168
People Shutdown    158,000,000
Workers Unpaid @15%    23,700,000
Total Shutdown Cost Per Day    3,971,345,985

4 Billion Per Day. I felt I was pretty conservative. That is a pretty big dang number. Please take a look at my numbers and let me know if you see anything that looks off.

My point remains this is a huge cost. How much of this can we tolerate?
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 24, 2020, 02:23:54 PM
Yep, completely not true.

Sure groceries continues, but so does utilities, banking, home maintenance, cleaning, freight transport, mining.... I could list so many industries.

DW went to a book store yesterday to buy a puzzle and the store keeper apologised because there had been a massive run on puzzles. They received additional stock that morning and by evening they were gone.

Everywhere you look you can see commerce.

I think that might have been a bit of hyperbole.

However the point remains you simply cannot surgically cut out 50% (or 25%, 10% etc) of the economy and expect the remainder to run long on its own.

If we can't restart in April I think we are going to have a hard time restarting at all. How long are we willing to wait? How bad of a depression are we willing to stand on the side of safety?

Remember folks almost all of us on here are in most measurements freaking rich! So that has to cloud our judgement some. Sure we will likely be fine, but we are a tiny subset of the world as a whole. Lots of people simply cannot miss a week of work and stay afloat. Even more cant miss a month, let alone 2-3.

We need everyone to make the economy work, savers/spenders, rich and poor. Lets all stay home now, but we gotta get back out there sooner rather than later.

Right, that's why we need to give people who cant work due to this money. We need to take money from the people that are "rich" and working and give it to those who cant work. Getting thru this short term shutdown sounds like an accounting problem to me. The real capital (humans and organizations) that drive the economy isn't going to go away if 30% of workers stay home for a few months.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 24, 2020, 02:27:04 PM
So lets do some math shall we? This is what I got about what this is costing us.

GDP    20,000,000,000,000
Daily GDP    54,794,520,548
US population    327,000,000
Daily GDP Per Person    168
People Shutdown    158,000,000
Workers Unpaid @15%    23,700,000
Total Shutdown Cost Per Day    3,971,345,985

4 Billion Per Day. I felt I was pretty conservative. That is a pretty big dang number. Please take a look at my numbers and let me know if you see anything that looks off.

My point remains this is a huge cost. How much of this can we tolerate?

Thanks for doing the back of the napkin math but the number of "people shutdown" is way off. There are only about 158 million workers in the US, obviously not all of them are unemployed due to this.

Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on March 24, 2020, 02:28:25 PM
Maybe in a few years, we'll be saying this: "In the end, it wasn't the rise of AI that brought us a UBI. It was a humble virus."
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on March 24, 2020, 02:29:29 PM
Yep, completely not true.

Sure groceries continues, but so does utilities, banking, home maintenance, cleaning, freight transport, mining.... I could list so many industries.

DW went to a book store yesterday to buy a puzzle and the store keeper apologised because there had been a massive run on puzzles. They received additional stock that morning and by evening they were gone.

Everywhere you look you can see commerce.

I think that might have been a bit of hyperbole.

However the point remains you simply cannot surgically cut out 50% (or 25%, 10% etc) of the economy and expect the remainder to run long on its own.

If we can't restart in April I think we are going to have a hard time restarting at all. How long are we willing to wait? How bad of a depression are we willing to stand on the side of safety?

Remember folks almost all of us on here are in most measurements freaking rich! So that has to cloud our judgement some. Sure we will likely be fine, but we are a tiny subset of the world as a whole. Lots of people simply cannot miss a week of work and stay afloat. Even more cant miss a month, let alone 2-3.

We need everyone to make the economy work, savers/spenders, rich and poor. Lets all stay home now, but we gotta get back out there sooner rather than later.

Right, that's why we need to give people who cant work due to this money. We need to take money from the people that are "rich" and working and give it to those who cant work. Getting thru this short term shutdown sounds like an accounting problem to me. The real capital (humans and organizations) that drive the economy isn't going to go away if 30% of workers stay home for a few months.

1% of people in the US own about 40% of the wealth.  Seems goofy.  I think it would make sense to skim a little off the top.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 24, 2020, 02:33:15 PM
So lets do some math shall we? This is what I got about what this is costing us.

GDP    20,000,000,000,000
Daily GDP    54,794,520,548
US population    327,000,000
Daily GDP Per Person    168
People Shutdown    158,000,000
Workers Unpaid @15%    23,700,000
Total Shutdown Cost Per Day    3,971,345,985

4 Billion Per Day. I felt I was pretty conservative. That is a pretty big dang number. Please take a look at my numbers and let me know if you see anything that looks off.

My point remains this is a huge cost. How much of this can we tolerate?

Thanks for doing the back of the napkin math but the number of "people shutdown" is way off. There are only about 158 million workers in the US, obviously not all of them are unemployed due to this.

Also, the GDP per capita assumes we communists and we all make the same amount of money (around 67k per year), in reality we have massive inequality in the US. The sad truth is that the people that will lose their jobs to this have some of the lowest wages, the good thing about that is the rest of us could have an easier time paying them for their missed work during this event.

Title: Re: How long can we wait while flattening the curve?
Post by: stoaX on March 24, 2020, 02:40:48 PM
Trump is chomping at the bit to end the quarantines and social distancing because it's hurting his economic numbers and chance of re-election.  Just more proof that he doesn't really care about American lives and overwhelmed hospitals.   It's all about him.

https://www.cnn.com/2020/03/23/politics/trump-coronavirus-15-days-social-distancing/index.html

Or his complete lack of attention span. We've quantified his attention span: 15 days.

How much of the shutdowns and quarantines are due to the federal government and how much is done at the state and local level?  It seems to me more at the state and local level so Trump may have limited influence on whether the economy opens up again and to what extent.
Title: Re: How long can we wait while flattening the curve?
Post by: LaineyAZ on March 24, 2020, 02:43:38 PM

 . . . . .Right, that's why we need to give people who cant work due to this money. We need to take money from the people that are "rich" and working and give it to those who cant work. Getting thru this short term shutdown sounds like an accounting problem to me. The real capital (humans and organizations) that drive the economy isn't going to go away if 30% of workers stay home for a few months.
[/quote]

Agree.  I haven't seen any proposals to rescind that ridiculous 2018 tax cut/giveaway to the wealthy.  If those who benefited the most - 2/3 of the cuts went to the top 20% of earners - are truly concerned about this pandemic and financial fallout, they would be in favor of returning to the pre-Trump tax levels.  This would help alleviate the financial strain and help reduce the huge national debt.
Title: Re: How long can we wait while flattening the curve?
Post by: Telecaster on March 24, 2020, 02:49:01 PM
I remain cautiously optimistic.  Unlike 2008 or the 1970s, there is nothing wrong with the economy itself.    Unemployment figures come out on Thursday, I suspect they will shatter every record.   Certainly a lot of people will be out of work, and there will be lots of lost business.  This will cause lots of real and permanent damage that will take a while to sort out.  But it won't take forever.  And we won't have to wait for banks to start making loans again, or for high interest rates to crush inflation.  The government is throwing a couple trillion at this thing, and it will probably take a couple trillion more.  But as long as people have money in their pocket, when the smoke clears they'll start to spend it again. 

Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on March 24, 2020, 02:52:57 PM
...there is nothing wrong with the economy itself.

was nothing wrong.

good luck to the thousands of businesses that will no longer exist in a month.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 24, 2020, 02:55:58 PM
as someone who is working full time remotely during this an hasnt missed a minute of work or a paycheck, im looking for ways to give money to the service workers i depend on during this. for example paying for a haircut that I usually get but wont this month, paying my local bar for the beer I would have drank but didnt drink. Id rather the govt step in and just pay people who have to shut down their buisnesses most or all of what they would normally make and raise taxes to pay for it.

I will tell you one thing I am learning from this: The USA is ABSOLUTELY RUTHLESS in its pursuit of world economic dominance. This event just proves that we value keeping stocks afloat more than keeping food on peoples table, value profits and low taxes, more than healthcare, etc. No other first world country can compete with us because they all take care of their people first. The texas gov just postulated that older americans are okay with dying to "save" the economy:
https://www.usatoday.com/story/news/nation/2020/03/24/covid-19-texas-official-suggests-elderly-willing-die-economy/2905990001/
un-fucking-real and the reason I invest in american companies!


Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 24, 2020, 03:06:33 PM
...there is nothing wrong with the economy itself.

was nothing wrong.

good luck to the thousands of businesses that will no longer exist in a month.

only if we're too cheap to save them. what's going to happen is that rather than pony up to save them we are going to let additional people suffer and die so we can "open the economy" sooner, something has to give, its your money or their life. in 1944 the top tax rate in the U.S. was 94%, think we're ready to tap into the wealth at the top to save lives and businesses? neither do I.
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 24, 2020, 04:36:14 PM
I dislike Trump strongly too, but his point "the cure can't be worse than the disease" (paraphrasing) is true.

Are we willing to spend many trillions of dollars and collapse our economy to (maybe) save something like a million mostly elderly people?

I don't have an answer for that, but based on how we value human life in other situations with limited resources, the answer is probably "no" from a utilitarian perspective.

There's enough uncertainty about the costs on both sides of the equation that it's not cut and dried, though. The economic damage might be much greater and the lives saved less, or the economic damage might be minimal/business as usual soon and the risk to life far greater.

-W

That's the thing.  We don't really know.  FWIW, CDC reports something like 30% of hospitalizations are people under 65 (approx. number).   There is a wide range of estimates of how many might get infected with no mitigation, ranging from many tens to hundreds of millions.  If even a small percentage of those require hospitalization, we would completely wipe out all of our health care capacity in this country, which would cause many needless deaths not only among COVID patients, but among the rest of the population too.   

Then we have however many people too sick too work.  There's a cost there.  And many people survive COVID with permanent disabilities.  There's a cost there, too.

Exactly.  We must keep the social separation, isolation, lockdowns, stay-at-home guidelines and orders in place, at least until the healthcare facilities can manage the massive amount of patients, and not just large cities on the coasts that are seeing large numbers but also across the country in many locations that have yet to see the caseload explode, yet they already can't get enough PPE equipment!  We can't take our feet off the breaks.  And unlike the Governor of Texas, who would get special priority treatment, I'm not willing to sacrifice my older family, friends, and aquaintenances, nor the younger ones with underlying conditions, or even the younger healthy ones that are among that age group that becomes critically ill.

Another thing I read is that taking our foot off the brakes would probably result in twice as many deaths not to mention how harmful it would be to the healthcare system for years to come after dealing with that tragic outcome.  PTSD and more.  I don't even see it as an option at this point.  From what I've been reading, almost all health care experts agree with me, not Trump and FOX News.
Title: Re: How long can we wait while flattening the curve?
Post by: Mr. Green on March 24, 2020, 04:50:42 PM
It's an all or nothing situation, and unfortunately we're not doing either. Both all and nothing would get this over with quickly, either with a lot of dead people or not, but the point is the economic engine could go back to running at full throttle. Instead, we're leaving the choke on and it's just sputtering because we're locking down areas where it spikes but not others. So people are going to continue to travel, and not think the situation is bad enough to stay home because there are still plenty of places not locked down, and that will just cause the outbreaks to hop from place to place until this whole thing has run its course. And that's assuming you can only get it once. If you can get it every year like the flu we're in for a total change in civilization without a total lockdown.

ETA: The irony of this post, coming from a guy who was asking if he should delay his multi-month camping trip is not lost on me. However, we're talking very different kinds of travel. As far as I'm concerned, if you can travel, interact with basically no one, and take proper safety precautions, you're extremely low risk. But 99% of the country doesn't travel like that.
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 24, 2020, 05:02:52 PM
Instead, we're leaving the choke on and it's just sputtering because we're locking down areas where it spikes but not others.

That's not really true.  I mean, there are whole states with state-at-home orders where there are still a majority of counties without a single confirmed case.  More states have joined in that since my state did.  I saw a map recently that I wanted to attach, but I was unable to locate it now.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 24, 2020, 05:21:26 PM
From what I've been reading, almost all health care experts agree with me, not Trump and FOX News.

It's their job to advocate that. They're not being asked to made a decision about tradeoffs, they are being asked how to save the maximum number of lives, regardless of cost.

It's like you asking me (I own a small bike company) how to put together the best bike. I'll come back to you with something that costs $20k and your eyes will bug out.

Ask me what I should get if my price limit is $2000, and you'll get a very different answer. Is the $20k bike objectively nicer/lighter/better than the $2k bike? Yes. Is it worth the extra $18k to you? Almost certainly not.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 24, 2020, 05:31:34 PM
From what I've been reading, almost all health care experts agree with me, not Trump and FOX News.

It's their job to advocate that. They're not being asked to made a decision about tradeoffs, they are being asked how to save the maximum number of lives, regardless of cost.

To be clear, I've read plenty of input from all sides, and I haven't seen anything sway my viewpoint that we need to stay the course based on results, not on picking an random date from the calendar as Trump has and saying everything will magically be ok, then.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 24, 2020, 05:43:42 PM
From what I've been reading, almost all health care experts agree with me, not Trump and FOX News.

It's their job to advocate that. They're not being asked to made a decision about tradeoffs, they are being asked how to save the maximum number of lives, regardless of cost.

It's like you asking me (I own a small bike company) how to put together the best bike. I'll come back to you with something that costs $20k and your eyes will bug out.

Ask me what I should get if my price limit is $2000, and you'll get a very different answer. Is the $20k bike objectively nicer/lighter/better than the $2k bike? Yes. Is it worth the extra $18k to you? Almost certainly not.

-W

OT, but do you seriously offer $20k bikes?  I’ve seen bikes that cost $6k, but never $20k.
What would it even have?  Top group sets are under $3k (from what I know).

Genuinely curious.
Title: Re: How long can we wait while flattening the curve?
Post by: MKinVA on March 24, 2020, 06:01:02 PM
I just don't think the economy is going to go down the tubes if we take a few weeks nonpublic to beat this thing. In my own large family, most are working from home at the same rate as they do in the office. Kids may be home from school, but we are still paying the teachers. My niece is still selling real estate (closing last week online and got a new client today), another works for Capital One and going strong, daughter works for medical insurance, brother works for grocery company, sister-in-law is a nurse, another brother is in broadcasting. We have lawyers working from home, even a nephew whose job at a restaurant is secure for now cause they are doing take out.

Amazon is hiring, Kroger grocery is hiring, hospitals are hiring. I am not trying to belittle anyone who has lost their job, but Congress is coming to an agreement where they will be paid through unemployment and direct payments. Will it be easy? No. During the Great Depression men were given a shovel and sent to the mountains to create our beautiful national parks. They were paid money to send home if they had family and given room and board as partial payment. People did not have food. So I am feeling pretty confident that we will get through this without people giving their lives for it.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 24, 2020, 06:04:19 PM
Amazon is hiring, Kroger grocery is hiring, hospitals are hiring.

Yup, I have a friend that works at Kroger. She's never got this much overtime before. They'll let her work seven days a week if she wants to.
Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate on March 24, 2020, 06:09:04 PM
OT, but do you seriously offer $20k bikes?  I’ve seen bikes that cost $6k, but never $20k.
What would it even have?  Top group sets are under $3k (from what I know).
Genuinely curious.

Wouldn't $20k be on the low end for an Olympic velodrome bike?
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 24, 2020, 06:32:20 PM
OT, but do you seriously offer $20k bikes?  I’ve seen bikes that cost $6k, but never $20k.
What would it even have?  Top group sets are under $3k (from what I know).

Genuinely curious.

LOL, no. I mean, I could spec one out if you held a gun to my head, but most of my bikes end up in the $4-5k range. Still stupid expensive, but not $20k.

Really, really nice set of wheels can be $3-4k by itself. And you can go a bit crazy with fancy small-batch German carbon seatposts and such. $20k road bikes are definitely a reality - they are jokingly referred to as "dentist bikes" in the industry.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on March 24, 2020, 07:15:20 PM
From what I've been reading, almost all health care experts agree with me, not Trump and FOX News.

It's their job to advocate that. They're not being asked to made a decision about tradeoffs, they are being asked how to save the maximum number of lives, regardless of cost.

It's like you asking me (I own a small bike company) how to put together the best bike. I'll come back to you with something that costs $20k and your eyes will bug out.

Ask me what I should get if my price limit is $2000, and you'll get a very different answer. Is the $20k bike objectively nicer/lighter/better than the $2k bike? Yes. Is it worth the extra $18k to you? Almost certainly not.

-W

OT, but do you seriously offer $20k bikes?  I’ve seen bikes that cost $6k, but never $20k.
What would it even have?  Top group sets are under $3k (from what I know).

Genuinely curious.

I don't know that I've ever seen a $20k bike, but I've seen plenty of $10-$12k mountain bikes. Mine was just shy of $6k new (I bought it used) and it doesn't even have a factory level fork.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 24, 2020, 08:44:07 PM
Thought this was interesting and relevant:
https://theincidentaleconomist.com/wordpress/economic-cost-of-flattening-the-curve/

They conclude:
"Our calculations suggest that current strategies will be cost effective only if the predicted mortality rates are at the top of the predicted range and costs are at the bottom of the range – a combination of worst care / best case that is unlikely. Consideration of targeted mitigation strategies that minimize the economic cost while protecting the most vulnerable are warranted."

-W
Title: Re: How long can we wait while flattening the curve?
Post by: Luz on March 24, 2020, 10:10:13 PM
Thought this was interesting and relevant:
https://theincidentaleconomist.com/wordpress/economic-cost-of-flattening-the-curve/

They conclude:
"Our calculations suggest that current strategies will be cost effective only if the predicted mortality rates are at the top of the predicted range and costs are at the bottom of the range – a combination of worst care / best case that is unlikely. Consideration of targeted mitigation strategies that minimize the economic cost while protecting the most vulnerable are warranted."

-W

I don't know why it's taken the economy starting to spiral for people to realize that "targeted mitigation strategies" are the way to go. The way I see it, it's not so much if the costs/benefits are worth it, but is what we're doing effective in both the short and long term and with possible consequences in mind?

In the opinion piece linked to the article you posted, the author David Katz, in talking about our current containment strategy, states: "...I fear our efforts will do little to contain the virus, because we have a resource-constrained, fragmented, perennially underfunded public health system. Distributing such limited resources so widely, so shallowly and so haphazardly is a formula for failure."

If what we're doing is effective, then I say bring on the economic costs. But oh my god, is it dumbfounding to have such high costs in relation to such a poorly applied approach. What countries have actually managed to flatten the curve and how have they done it (that's a rhetorical question)? We could do better.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 24, 2020, 10:43:59 PM
Thought this was interesting and relevant:
https://theincidentaleconomist.com/wordpress/economic-cost-of-flattening-the-curve/

They conclude:
"Our calculations suggest that current strategies will be cost effective only if the predicted mortality rates are at the top of the predicted range and costs are at the bottom of the range – a combination of worst care / best case that is unlikely. Consideration of targeted mitigation strategies that minimize the economic cost while protecting the most vulnerable are warranted."

-W

Pretty good article... To calculate the QALY they are attributing the total cost of the stimulus efforts (1-4 trillion) to combating coronavirus. Lets say we did'nt do anything that incurred an expense, no social distancing, no expanding healthcare capacity, no shutdowns of anything. Would the markets panic? Yes they would. Would they panic more than they are panicking now? I think so. Would a stimulus be needed? You betcha! So, the authors are attributing 100% of the vast cost of the stimulus to fighing the epidemic as if the money is being spent directly on something like cancer research or developing safer cars. But that's not how the stimulus money is being spent. Most of the stimulus money so far (over 1.5 trillion) has been used to calm fears in markets by increasing liquidity by injecting cash into various areas of the financial system. How much of the trillions is actually spent combating coronavirus as opposed to easing market fears is yet to be seen but that is the amount that should be used to calculate the QALY.

Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 25, 2020, 05:45:07 AM
I’m curious about how many businesses are truly and completely “shut down,” as opposed to altered but still operational. It’s easy to conclude that most of the economy has simply stopped when all non-essential public-facing businesses have closed their doors (e.g. restaurants, retail stores, bars) but many of us continue to work in some capacity, often remotely.

Just anecdotally most of my extended family and neighbors all seem to be working from home.  Sister and her husband (both in medical fields) are working overtime, spouse is a government employee still required to go into the office (!), and of her five siblings + three spouses only one has been completely furloughed. For many of them their offices are closed to the public, but they are toiling behind the scenes doing all the jobs that can be done remotely (inventory, redesigns, remote-classroom learning, etc)

I know that there are tens-of-millions who are not working right now, but reading this thread suggests the entire economy is at a standstill, which simply isn’t true. At the same time much of this work-from-home is a stop-gap measure that can’t last forever — in many sectors there’s only so much work that can be done remotely before people need to return to cranking out wickets or whatever it is they do.

We’ll get a glimpse tomorrow when the new unemployment numbers come in how many have truly been laid off, and that’s certain to grow.  I guess my point is that just because a business is technically ‘closed’ doesn’t mean no work is being done, and no profits are being generated (either immediately or for the near future).

...early morning musings...
Title: Re: How long can we wait while flattening the curve?
Post by: Miss Prim on March 25, 2020, 05:53:39 AM
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

Would you give up all of your money and possessions to save the life of your child, grandchild, or spouse?  I know I would.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 25, 2020, 06:17:00 AM
I just don't think the economy is going to go down the tubes if we take a few weeks nonpublic to beat this thing. In my own large family, most are working from home at the same rate as they do in the office. Kids may be home from school, but we are still paying the teachers. My niece is still selling real estate (closing last week online and got a new client today), another works for Capital One and going strong, daughter works for medical insurance, brother works for grocery company, sister-in-law is a nurse, another brother is in broadcasting. We have lawyers working from home, even a nephew whose job at a restaurant is secure for now cause they are doing take out.

Amazon is hiring, Kroger grocery is hiring, hospitals are hiring. I am not trying to belittle anyone who has lost their job, but Congress is coming to an agreement where they will be paid through unemployment and direct payments. Will it be easy? No. During the Great Depression men were given a shovel and sent to the mountains to create our beautiful national parks. They were paid money to send home if they had family and given room and board as partial payment. People did not have food. So I am feeling pretty confident that we will get through this without people giving their lives for it.

Everyone I know who is okay with a prolonged economic shutdown is working from home in their sweats and making full pay.  It is the height of "privilege" that I see many talk about in other contexts.

I at least hope the more fortunate among us can see beyond our own immediate families to see that this has been an unmitigated disaster, already, for millions of people.

My wife, who makes $45-50k a year, has basically lost her job.  She went from 30ish hours a week to 3 or 4.  There is great concern that the business, which employs about 200 people, might go under.  We are fortunate in that we maintain a low COL, I make a good income that can cover our bills, etc.  But I'm also aware enough to recognize that most people in my position would be absolutely fucked right now.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on March 25, 2020, 06:21:19 AM
I’m curious about how many businesses are truly and completely “shut down,” as opposed to altered but still operational. It’s easy to conclude that most of the economy has simply stopped when all non-essential public-facing businesses have closed their doors (e.g. restaurants, retail stores, bars) but many of us continue to work in some capacity, often remotely.

Just anecdotally most of my extended family and neighbors all seem to be working from home.  Sister and her husband (both in medical fields) are working overtime, spouse is a government employee still required to go into the office (!), and of her five siblings + three spouses only one has been completely furloughed. For many of them their offices are closed to the public, but they are toiling behind the scenes doing all the jobs that can be done remotely (inventory, redesigns, remote-classroom learning, etc)

I know that there are tens-of-millions who are not working right now, but reading this thread suggests the entire economy is at a standstill, which simply isn’t true. At the same time much of this work-from-home is a stop-gap measure that can’t last forever — in many sectors there’s only so much work that can be done remotely before people need to return to cranking out wickets or whatever it is they do.

We’ll get a glimpse tomorrow when the new unemployment numbers come in how many have truly been laid off, and that’s certain to grow.  I guess my point is that just because a business is technically ‘closed’ doesn’t mean no work is being done, and no profits are being generated (either immediately or for the near future).

...early morning musings...

My brother-in-law owns yeast business (supplying micro-breweries) that was doing phenomenally until 3 weeks ago.and he had to lay off everyone. He employed my brother as CTO and my dad, and my sister was a SAHM with 2 young kids. So it’s already pretty much left my family devastated and we’re not talking about servers here, just people who work for a small business. They said they saw an immediate 95% reduction in orders and they were prepared for a 50% reduction in orders.

Plus remember just because many of these businesses are still open today doesn’t mean they won’t be trimming their workforce if this goes on for another 6-8 weeks.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 25, 2020, 06:45:02 AM
I’m curious about how many businesses are truly and completely “shut down,” as opposed to altered but still operational. It’s easy to conclude that most of the economy has simply stopped when all non-essential public-facing businesses have closed their doors (e.g. restaurants, retail stores, bars) but many of us continue to work in some capacity, often remotely.

Just anecdotally most of my extended family and neighbors all seem to be working from home.  Sister and her husband (both in medical fields) are working overtime, spouse is a government employee still required to go into the office (!), and of her five siblings + three spouses only one has been completely furloughed. For many of them their offices are closed to the public, but they are toiling behind the scenes doing all the jobs that can be done remotely (inventory, redesigns, remote-classroom learning, etc)

I know that there are tens-of-millions who are not working right now, but reading this thread suggests the entire economy is at a standstill, which simply isn’t true. At the same time much of this work-from-home is a stop-gap measure that can’t last forever — in many sectors there’s only so much work that can be done remotely before people need to return to cranking out wickets or whatever it is they do.

We’ll get a glimpse tomorrow when the new unemployment numbers come in how many have truly been laid off, and that’s certain to grow.  I guess my point is that just because a business is technically ‘closed’ doesn’t mean no work is being done, and no profits are being generated (either immediately or for the near future).

...early morning musings...

My experience is anecdotal, but many businesses are taking liberties with Ohio's definition of "essential business."  The order had so many categories of "essential" business that many found a way to fit into that.  These are the businesses that have adjusted but are getting by.  I have one client doing half staff one week, half staff the next, and paying the non-working half.  Good on them.

But, any business that is not essential is getting absolutely crushed.  Almost every small business of mine -- restaurant, coffee shop, manufacturers, etc. -- are getting crushed.  Food service businesses cannot survive on takeout.  They just can't.  Interestingly, construction companies that do remodeling (instead of just new builds) are getting hammered (people don't want them in their homes).  It's a wasteland for these businesses.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on March 25, 2020, 07:05:59 AM
In a way we are finding out what it would be like if everyone embraced a mustachian lifestyle. Almost no eating out, no vacations, no going to bars/breweries, limited travel except via bike/walking. Focus on spending on food and essentials and finding cheap ways to keep yourself entertained.
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on March 25, 2020, 08:03:41 AM
Thought this was interesting and relevant:
https://theincidentaleconomist.com/wordpress/economic-cost-of-flattening-the-curve/

They conclude:
"Our calculations suggest that current strategies will be cost effective only if the predicted mortality rates are at the top of the predicted range and costs are at the bottom of the range – a combination of worst care / best case that is unlikely. Consideration of targeted mitigation strategies that minimize the economic cost while protecting the most vulnerable are warranted."

-W

Just to add to this, the WHO says that a nationwide health initiative typically makes sense if the cost per QALY is 1-3 times national GDP/capita.

https://www.who.int/bulletin/volumes/94/12/15-164418/en/

US GDP per capita was $63k in 2018, so by WHO standards the cost per QALY for the US would need to be $63-$189k. We're likely to overshoot that by quite a bit.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 25, 2020, 08:16:22 AM
In a way we are finding out what it would be like if everyone embraced a mustachian lifestyle. Almost no eating out, no vacations, no going to bars/breweries, limited travel except via bike/walking. Focus on spending on food and essentials and finding cheap ways to keep yourself entertained.
I don’t see that as “the mustache an lifestyle”. Such measures are encouraged only when one is in a debt emergency or hasn’t/isn’t saving much. Pete likes micro breweries in particular.
Title: Re: How long can we wait while flattening the curve?
Post by: Jack0Life on March 25, 2020, 08:36:53 AM
Its pretty incredible to think that you can have a very successful business and with a shutdown for just 1 month, you can go under. This is what happening to a lot of small business.
Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 25, 2020, 08:58:48 AM
Its pretty incredible to think that you can have a very successful business and with a shutdown for just 1 month, you can go under. This is what happening to a lot of small business.

Can you call a business that produces such little surplus "very successful"? Either the owner is paying himself/herself too much or there is something else wrong with the finances.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 09:00:35 AM
Would you give up all of your money and possessions to save the life of your child, grandchild, or spouse?  I know I would.

Sure, but that's not the question being asked here. If you feel human life is that valuable, you should immediately stop driving your car, for instance. That's just a silly convenience, and it endangers other people - even if you're a good driver, there's a non-zero chance you'll cause a fatal accident.

So, would you give up all your money and possessions to save someone you don't know, somewhere far away? You could save lives right now by giving away all your money, why haven't you?

-W
Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on March 25, 2020, 09:03:33 AM
Its pretty incredible to think that you can have a very successful business and with a shutdown for just 1 month, you can go under. This is what happening to a lot of small business.
I'd challenge whether that business is "very successful" if that is indeed true. Most small businesses are poorly managed and under-capitalized.

Most individuals are bad at managing their money, and small businesses often don't have the luxury of lots of employees available to pick out the ones who are good at that to manage their finances.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 25, 2020, 09:03:51 AM
Its pretty incredible to think that you can have a very successful business and with a shutdown for just 1 month, you can go under. This is what happening to a lot of small business.

Can you call a business that produces such little surplus "very successful"? Either the owner is paying himself/herself too much or there is something else wrong with the finances.

Both of these posts show an ignorance of how small business actually works.  The most successful of successful restaurants operate at maybe 5% profit.  Construction companies are 8-10% profit.  Retail are maybe 5-10% profit.

The huge difference between business and a household is that their profit margins are usually thin, and their expenses are usually large.

If it's a $5M annual business with a 10% profit margin (extremely successful!), you're talking roughly $420k in revenue a month, but also $385k in expenses a month.  When revenue gets completely shut off, you can only cut so many expenses without just shutting the doors entirely.

I do not know too many businesses that keep hundreds of thousands in reserves.

And we are talking successful businesses here.  I would posit that the vast majority of small businesses are operating at less than a five percent margin.  That's at least what I see from my clients.

Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 25, 2020, 09:22:38 AM
Its pretty incredible to think that you can have a very successful business and with a shutdown for just 1 month, you can go under. This is what happening to a lot of small business.

Can you call a business that produces such little surplus "very successful"? Either the owner is paying himself/herself too much or there is something else wrong with the finances.

Both of these posts show an ignorance of how small business actually works.  The most successful of successful restaurants operate at maybe 5% profit.  Construction companies are 8-10% profit.  Retail are maybe 5-10% profit.

The huge difference between business and a household is that their profit margins are usually thin, and their expenses are usually large.

If it's a $5M annual business with a 10% profit margin (extremely successful!), you're talking roughly $420k in revenue a month, but also $385k in expenses a month.  When revenue gets completely shut off, you can only cut so many expenses without just shutting the doors entirely.

I do not know too many businesses that keep hundreds of thousands in reserves.

And we are talking successful businesses here.  I would posit that the vast majority of small businesses are operating at less than a five percent margin.  That's at least what I see from my clients.

So that's my point. If you run a small business and the operating margin is under 5% you are probably not counted as "very successful", unless the reason the margin is so thin is because you're paying yourself 20% (in which case you can stop paying yourself). Very few restauranteurs/retailers make much money in the long run (for themselves) which just shows it's a tough industry and hard to be very successful in.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 25, 2020, 09:36:45 AM
So that's my point. If you run a small business and the operating margin is under 5% you are probably not counted as "very successful", unless the reason the margin is so thin is because you're paying yourself 20% (in which case you can stop paying yourself). Very few restauranteurs/retailers make much money in the long run (for themselves) which just shows it's a tough industry and hard to be very successful in.

You are just so off base here I'm having a hard time determining whether you are serious.  If you think businesses that aren't profitable is just because fatcat owners are paying themselves a high salary, you're just off base. You cannot just make any margin you want.  You have to charge what the market dictates.

In construction, a new-build and its materials cost what they cost.  Everyone knows the contractor is taking a cut.  You cannot simply charge 20% profit.  The client will go to another builder.  The industry standard is 5-10%.  It just is what it is.

Restaurants are the same.  They cannot charge whatever they want for food because customers will go elsewhere.

Grocery stores operate at a fraction of a percentage for profit, because customers will just go elsewhere.

The market mostly dictates a business's profits, not some asshole greedy owner.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 09:55:30 AM
Bloop, I run a small business and know lots of small business owners. You are just wrong about this. You can do a fantastic conscientious job and not pay yourself crazy money in many industries and still only be making 5-10%. That's just the reality. It is not a reflection on the owner of the business being bad at it or greedy.

Even if you're operating at an awesome margin, say 50% - if you have even half of your expenses as fixed ones (paying employees, insurance, rent for your space, etc) you'll go under pretty fast if revenue goes to zero suddenly. How much of your own money are you going to plow into paying rent on an empty restaurant every month? Better to close up shop and wait for better times - but that also means now your employees and landlord are SOL.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: Cassie on March 25, 2020, 09:56:44 AM
My kids are casino workers and are happy they are shutdown because they don’t want to fire for their jobs. If this goes on for months they will need to move in with us.
Title: Re: How long can we wait while flattening the curve?
Post by: Telecaster on March 25, 2020, 10:20:50 AM
Thought this was interesting and relevant:
https://theincidentaleconomist.com/wordpress/economic-cost-of-flattening-the-curve/

They conclude:
"Our calculations suggest that current strategies will be cost effective only if the predicted mortality rates are at the top of the predicted range and costs are at the bottom of the range – a combination of worst care / best case that is unlikely. Consideration of targeted mitigation strategies that minimize the economic cost while protecting the most vulnerable are warranted."

-W

That was quite interesting.  One quibble though:

Quote from: from the article
A pandemic that is likely to lead to 1.7 million deaths can justify the enormous public costs. However, if the pandemic is in the lower end of the predicted range, then the public funds would have been more valuable if spent elsewhere.

But the question isn't where to spend the funds.  The question is how much to spend on this issue, right?   In other words, the money we're currently spending on COVID isn't available to spend elsewhere in the health care system. 
Title: Re: How long can we wait while flattening the curve?
Post by: mm1970 on March 25, 2020, 10:45:11 AM
Instead, we're leaving the choke on and it's just sputtering because we're locking down areas where it spikes but not others.

That's not really true.  I mean, there are whole states with state-at-home orders where there are still a majority of counties without a single confirmed case.  More states have joined in that since my state did.  I saw a map recently that I wanted to attach, but I was unable to locate it now.
my state has a stay at home order, but that didn't prevent people from driving a few hours to rent a house for spring break.
Title: Re: How long can we wait while flattening the curve?
Post by: fattest_foot on March 25, 2020, 10:46:22 AM
Everyone I know who is okay with a prolonged economic shutdown is working from home in their sweats and making full pay.  It is the height of "privilege" that I see many talk about in other contexts.

I at least hope the more fortunate among us can see beyond our own immediate families to see that this has been an unmitigated disaster, already, for millions of people.

My wife, who makes $45-50k a year, has basically lost her job.  She went from 30ish hours a week to 3 or 4.  There is great concern that the business, which employs about 200 people, might go under.  We are fortunate in that we maintain a low COL, I make a good income that can cover our bills, etc.  But I'm also aware enough to recognize that most people in my position would be absolutely fucked right now.

Don't forget that most of us who are doing things like working from home or are not generally impacted by this are self selected. We have a bias circle that we interact with by where we live, the jobs we have, etc. Even your grocery store is probably staffed by people that are more well off just because they work at the grocery store YOU go to.
Title: Re: How long can we wait while flattening the curve?
Post by: mm1970 on March 25, 2020, 10:47:59 AM
I just don't think the economy is going to go down the tubes if we take a few weeks nonpublic to beat this thing. In my own large family, most are working from home at the same rate as they do in the office. Kids may be home from school, but we are still paying the teachers. My niece is still selling real estate (closing last week online and got a new client today), another works for Capital One and going strong, daughter works for medical insurance, brother works for grocery company, sister-in-law is a nurse, another brother is in broadcasting. We have lawyers working from home, even a nephew whose job at a restaurant is secure for now cause they are doing take out.

Amazon is hiring, Kroger grocery is hiring, hospitals are hiring. I am not trying to belittle anyone who has lost their job, but Congress is coming to an agreement where they will be paid through unemployment and direct payments. Will it be easy? No. During the Great Depression men were given a shovel and sent to the mountains to create our beautiful national parks. They were paid money to send home if they had family and given room and board as partial payment. People did not have food. So I am feeling pretty confident that we will get through this without people giving their lives for it.

Everyone I know who is okay with a prolonged economic shutdown is working from home in their sweats and making full pay.  It is the height of "privilege" that I see many talk about in other contexts.

I at least hope the more fortunate among us can see beyond our own immediate families to see that this has been an unmitigated disaster, already, for millions of people.

My wife, who makes $45-50k a year, has basically lost her job.  She went from 30ish hours a week to 3 or 4.  There is great concern that the business, which employs about 200 people, might go under.  We are fortunate in that we maintain a low COL, I make a good income that can cover our bills, etc.  But I'm also aware enough to recognize that most people in my position would be absolutely fucked right now.
I'm okay with a prolonged shutdown, but I'm a mustachian and we are both working from home BUT I also think that our tax dollars should go to making sure that everyone who isn't working has a roof and is fed.

I mean, we should do that normally, and we don't. 
Title: Re: How long can we wait while flattening the curve?
Post by: fattest_foot on March 25, 2020, 10:50:43 AM
Bloop, I run a small business and know lots of small business owners. You are just wrong about this. You can do a fantastic conscientious job and not pay yourself crazy money in many industries and still only be making 5-10%. That's just the reality. It is not a reflection on the owner of the business being bad at it or greedy.

Even if you're operating at an awesome margin, say 50% - if you have even half of your expenses as fixed ones (paying employees, insurance, rent for your space, etc) you'll go under pretty fast if revenue goes to zero suddenly. How much of your own money are you going to plow into paying rent on an empty restaurant every month? Better to close up shop and wait for better times - but that also means now your employees and landlord are SOL.

-W

It's also a ridiculous statement to make. "Why aren't these businesses holding months of cash?" Are you serious? You realize that cash for a business sitting idle could be much better used to...make more cash flow?
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on March 25, 2020, 11:17:38 AM
Bloop, I run a small business and know lots of small business owners. You are just wrong about this. You can do a fantastic conscientious job and not pay yourself crazy money in many industries and still only be making 5-10%. That's just the reality. It is not a reflection on the owner of the business being bad at it or greedy.

Even if you're operating at an awesome margin, say 50% - if you have even half of your expenses as fixed ones (paying employees, insurance, rent for your space, etc) you'll go under pretty fast if revenue goes to zero suddenly. How much of your own money are you going to plow into paying rent on an empty restaurant every month? Better to close up shop and wait for better times - but that also means now your employees and landlord are SOL.

-W

It's also a ridiculous statement to make. "Why aren't these businesses holding months of cash?" Are you serious? You realize that cash for a business sitting idle could be much better used to...make more cash flow?

Yup, my bro-in-law was in the process of building a new building to increase capacity and offer a tap-room like experience where people could see the impact different yeast strands had on the same beers. You can't just stop paying the contractors because your revenue dried up in a month. Most businesses have contingency plans to deal with temporary drops in revenue. He had one for a 50% drop. But why would anyone build a contingency plan for a 90-95% drop in monthly revenue? At that point, your thought is the business has failed. But clearly that's not going to be the case for most of these small businesses. He went from consistent demand growth to no demand in the period of a few weeks.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 25, 2020, 11:25:14 AM
Would you give up all of your money and possessions to save the life of your child, grandchild, or spouse?  I know I would.

Sure, but that's not the question being asked here. If you feel human life is that valuable, you should immediately stop driving your car, for instance. That's just a silly convenience, and it endangers other people - even if you're a good driver, there's a non-zero chance you'll cause a fatal accident.

So, would you give up all your money and possessions to save someone you don't know, somewhere far away? You could save lives right now by giving away all your money, why haven't you?

-W

The car driving analogy doesnt make sense. Transportation is necessary. If people didnt drive they would use some other form of transportation which would also have a fatality rate.

Also, Coronavirus is actually far deadlier than the flu or car crashes
In 2018, roughly 36,560 people died in automobile accidents. Another 38,000 died from flu-related causes in the winter ending that same year.

We don’t yet know how many deaths the coronavirus will cause. But a recent study pegged the mortality rate for symptomatic coronavirus cases at 1.4 percent. That may not sound devastating in a vacuum, but it is significant, as that rate means the coronavirus could kill up to 1.1 million Americans if allowed to spread unchecked.

Also, ya'all are attributing the entire cost of the stimulus and lost the lost jobs to control and response efforts. If we did nothing, no forced closures the markets would still be freaking out and lots of people would be losing their jobs and we would still have a stimulus. I think the markets would actually freak out more and the background problem would be worse.


Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 11:30:13 AM
Fatality rates for riding the bus are a tiny fraction of those for driving cars. You'd also have less pollution, which definitely saves lives in many places, and less GHG emissions - which you could argue will save lives in the future.

Your car is killing people. Yet we both own and drive them.

To use another transportation example, there's no need to drive 75 on the freeway. We could set the speed limit to 40, and it would MASSIVELY reduce fatalities. But we don't, because we don't place an infinite value on life.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 25, 2020, 11:39:41 AM
Fatality rates for riding the bus are a tiny fraction of those for driving cars.

To use another transportation example, there's no need to drive 75 on the freeway. We could set the speed limit to 40, and it would MASSIVELY reduce fatalities. But we don't, because we don't place an infinite value on life.

-W

We did this to some degree back in the 1970s in response to the oil crisis; to receive federal transportation funding all interstates had to have their speeds no higher than 55mph (the 'National Maximum Speed Law').  Vehicular fatalities went down.  Fuel efficiency rose (slightly).  But of course convenience and speed ultimately won out over safety and the environment. 'Course improvements to safety  features (speedbelts, crumple zones) and increased urbanization makes correlations difficult.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 25, 2020, 11:51:58 AM
Seems like we all agree then that we should have slower speed limits, and ride the bus more, and have a coronavirus response!

But you're not accounting for the fact that Coronavirus is actually far deadlier than the flu or car crashes
In 2018, roughly 36,560 people died in automobile accidents. Another 38,000 died from flu-related causes in the winter ending that same year.

We don’t yet know how many deaths the coronavirus will cause. But a recent study pegged the mortality rate for symptomatic coronavirus cases at 1.4 percent. That may not sound devastating in a vacuum, but it is significant, as that rate means the coronavirus could kill up to 1.1 million Americans if allowed to spread unchecked.

If your point is that there should be a limit on how much we spend to save 1.1 million americans I agree with you but you haven't provided any evidence that we're spending too much an/d you're not comparing apples to apples because doing nothing has economic consequences.

Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 11:59:13 AM
Seems like we all agree then that we should have slower speed limits, and ride the bus more, and have a coronavirus response!

But we don't ride the bus or lower the speed limit. That was my point. We have already placed a value on life, we just don't like to talk about it.

Your point that the death rate/danger is a relative unknown is well taken, as is the fact that some economic damage will result either way.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 25, 2020, 12:00:18 PM
Seems like we all agree then that we should have slower speed limits
how did you conclude that?
Title: Re: How long can we wait while flattening the curve?
Post by: bigblock440 on March 25, 2020, 12:08:35 PM
...there is nothing wrong with the economy itself.

was nothing wrong.

good luck to the thousands of businesses that will no longer exist in a month.

only if we're too cheap to save them. what's going to happen is that rather than pony up to save them we are going to let additional people suffer and die so we can "open the economy" sooner, something has to give, its your money or their life. in 1944 the top tax rate in the U.S. was 94%, think we're ready to tap into the wealth at the top to save lives and businesses? neither do I.

In 1944, we were fighting the Nazis and Japanese, and had been for 3 years.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 25, 2020, 12:09:09 PM
Seems like we all agree then that we should have slower speed limits, and ride the bus more, and have a coronavirus response!

But we don't ride the bus or lower the speed limit. That was my point. We have already placed a value on life, we just don't like to talk about it.

Your point that the death rate/danger is a relative unknown is well taken, as is the fact that some economic damage will result either way.

-W

Oh, i understand we've already placed a value on life. its done all day long in the courts and by insurance companies.

You seem to be saying that covid is just as deadly as driving and the flu, but its clearly orders of magnitude more deadly. We might not know exactly how many people will die from covid but no credible source is saying its comparable to the flu or driving. Have you looked at the actual death rates for driving/getting the flu/and getting covid? Its far more deadly.


Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 25, 2020, 12:22:06 PM
Katy Tur's Twitter account has been excellent highlighting small business owners.  She is crowdsourcing videos.  Highlights:

Bagel shop had 120 employees, then zero
Other bagel shop had 135 employees, now 12
Atlanta restaraunt had 40 employees, now zero
NYC restaraunt had 31 employees, only two more weeks to pay payroll
Yoga studio in Tribeca had 3 FT, 20 PT employees, now all furloughed
Tavern in Georgia had 14 employees, now 2
Construction company in New York went from 16 employees to 7

***

It's going to be far, far, far worse than you think.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 12:23:54 PM
Oh, i understand we've already placed a value on life. its done all day long in the courts and by insurance companies.

You seem to be saying that covid is just as deadly as driving and the flu, but its clearly orders of magnitude more deadly. We might not know exactly how many people will die from covid but no credible source is saying its comparable to the flu or driving. Have you looked at the actual death rates for driving/getting the flu/and getting covid? Its far more deadly.

No, if you think that's what I'm saying, then you're misreading me. My use of the driving cars analogy was purely to say that we do indeed place a value on human life, and that we should use such metrics to inform our decisionmaking now, rather than just doing *anything* we can to prevent deaths.

I have no evidence to suggest you are wrong that Covid-19 is more dangerous than automobiles (you could get into quite a debate about GHG emissions and climate change, though, I suppose) and if that's what you think I'm saying, you can rest east, because it's not. I don't think I said anything like that anywhere in the thread, but I'm not always a perfect communicator.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: Telecaster on March 25, 2020, 12:27:24 PM
Also, ya'all are attributing the entire cost of the stimulus and lost the lost jobs to control and response efforts. If we did nothing, no forced closures the markets would still be freaking out and lots of people would be losing their jobs and we would still have a stimulus. I think the markets would actually freak out more and the background problem would be worse.

This is an important point.  Many restaurants in Seattle had already closed before the shutdown order simply because there wasn't enough business.  Let's say we let this thing run its course and we get into a Spain situation where morgues and undertakers are overwhelmed and the military has to collect bodies from nursing homes and store them in a hockey rink.  I guarantee there will be Grade A freakout that point (we might get there regardless).  And of course, our medical system will be even more overwhelmed and  victims of heart attacks, strokes, and car accidents  won't get  treatment.   Getting a check up for your hypertension will be unthinkable.  How much will that cost? 

The Imperial College London study estimated there would be 2.2 million deaths if this thing is unchecked.  Even if the number is a third of that, that's still more Americans than were killed in all of the wars of the 20th century. 

On top of that, we still don't really know what we are dealing with.  We can't do contact tracing, a vital step if we want to return to normalcy.  Until we can figure some of this out, we have one choice and that's to keep things shut down.  That's a bad option, but the alternatives are worse. 
Title: Re: How long can we wait while flattening the curve?
Post by: ender on March 25, 2020, 12:49:14 PM
Katy Tur's Twitter account has been excellent highlighting small business owners.  She is crowdsourcing videos.  Highlights:

Bagel shop had 120 employees, then zero
Other bagel shop had 135 employees, now 12
Atlanta restaraunt had 40 employees, now zero
NYC restaraunt had 31 employees, only two more weeks to pay payroll
Yoga studio in Tribeca had 3 FT, 20 PT employees, now all furloughed
Tavern in Georgia had 14 employees, now 2
Construction company in New York went from 16 employees to 7

***

It's going to be far, far, far worse than you think.

One thing I've noticed is that because most people tend to associate with people in similar socioeconomic status, it's hard to understand the impact on people in different areas there.

I have extended family who basically have to get second jobs because they work for a newspaper which basically lost all its ad revenue.

It's obviously hitting the initial wave of businesses that are in the service industry but very quickly will start resulting in secondary/tertiary economic impacts.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 25, 2020, 01:19:06 PM
Oh, i understand we've already placed a value on life. its done all day long in the courts and by insurance companies.

You seem to be saying that covid is just as deadly as driving and the flu, but its clearly orders of magnitude more deadly. We might not know exactly how many people will die from covid but no credible source is saying its comparable to the flu or driving. Have you looked at the actual death rates for driving/getting the flu/and getting covid? Its far more deadly.

No, if you think that's what I'm saying, then you're misreading me. My use of the driving cars analogy was purely to say that we do indeed place a value on human life, and that we should use such metrics to inform our decisionmaking now, rather than just doing *anything* we can to prevent deaths.

I have no evidence to suggest you are wrong that Covid-19 is more dangerous than automobiles (you could get into quite a debate about GHG emissions and climate change, though, I suppose) and if that's what you think I'm saying, you can rest east, because it's not. I don't think I said anything like that anywhere in the thread, but I'm not always a perfect communicator.

-W

yeah well if you want an accurate cost per life/year of life saved for covid you're not going to get it for awhile. we simply dont have the data. we simply wont know if the cure is worse than the problem or vice-versa for quite some time. if you want to blame someone blame nature. I dont think we're doing *anything* we can now to save lives due to covid, where i live we cant even test people that have symptoms. most states dont even have closures: https://abcnews.go.com/Health/states-shut-essential-businesses-map/story?id=69770806

Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 25, 2020, 01:20:56 PM
Katy Tur's Twitter account has been excellent highlighting small business owners.  She is crowdsourcing videos.  Highlights:

Bagel shop had 120 employees, then zero
Other bagel shop had 135 employees, now 12
Atlanta restaraunt had 40 employees, now zero
NYC restaraunt had 31 employees, only two more weeks to pay payroll
Yoga studio in Tribeca had 3 FT, 20 PT employees, now all furloughed
Tavern in Georgia had 14 employees, now 2
Construction company in New York went from 16 employees to 7

***

It's going to be far, far, far worse than you think.

One thing I've noticed is that because most people tend to associate with people in similar socioeconomic status, it's hard to understand the impact on people in different areas there.

I have extended family who basically have to get second jobs because they work for a newspaper which basically lost all its ad revenue.

It's obviously hitting the initial wave of businesses that are in the service industry but very quickly will start resulting in secondary/tertiary economic impacts.

This Bloomberg article is the second wave you're talking about.  https://www.bloomberg.com/news/articles/2020-03-24/u-s-retailers-plan-to-stop-paying-rent-to-offset-virus-closures

I only tangentially dabble in commercial litigation cases, but this is going to be an absolute clusterfuck in a month or two.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 25, 2020, 01:28:55 PM
The Imperial College London study estimated there would be 2.2 million deaths if this thing is unchecked.  Even if the number is a third of that, that's still more Americans than were killed in all of the wars of the 20th century. 

I'm starting to see a lot of scientific pushback on the Imperial College Study's projections.  Specifically, many scientists think they drastically over-estimate the R0 factor of asymptomatic people, the required hospitalization rate, and the exponential nature of the virus.

The Imperial College Study predicted a *minimum* of 1.1 million deaths EVEN IF (!!!) we did three months of strict suppression.  Will be interesting to see if that pans out.
Title: Re: How long can we wait while flattening the curve?
Post by: Boofinator on March 25, 2020, 01:30:12 PM
Also, ya'all are attributing the entire cost of the stimulus and lost the lost jobs to control and response efforts. If we did nothing, no forced closures the markets would still be freaking out and lots of people would be losing their jobs and we would still have a stimulus. I think the markets would actually freak out more and the background problem would be worse.

That's my observation as well. These restaurants and other service-related industries would have seen exactly the same collapse absent any government-directed stay-at-home measures, though delayed by a few weeks (until the general public witnessed the carnage first-hand and began freaking out).
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on March 25, 2020, 01:37:27 PM
Also, ya'all are attributing the entire cost of the stimulus and lost the lost jobs to control and response efforts. If we did nothing, no forced closures the markets would still be freaking out and lots of people would be losing their jobs and we would still have a stimulus. I think the markets would actually freak out more and the background problem would be worse.

That's my observation as well. These restaurants and other service-related industries would have seen exactly the same collapse absent any government-directed stay-at-home measures, though delayed by a few weeks (until the general public witnessed the carnage first-hand and began freaking out).

It might have been more complicated laying off their staff when half of them are on sick leave though.
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 25, 2020, 01:40:13 PM
No, if you think that's what I'm saying, then you're misreading me. My use of the driving cars analogy was purely to say that we do indeed place a value on human life, and that we should use such metrics to inform our decisionmaking now, rather than just doing *anything* we can to prevent deaths.
I'm curious, do you think we are currently near the extreme of doing "anything" we can to prevent deaths, or are you arguing an academic point?

I agree that there should be some cost/benefit analysis done. However, I strongly believe that the value we put on a single life when contemplating things like the cost/benefit of redesigning seat belts in a vehicle, or even lowering emissions from a coal power plant, are not applicable when the entire society is at risk.

I mean, suppose that we put the value of a life at $1 million. That would mean that if the entire nation was at risk of dying, let's say from an asteroid impact, any measures that cost more than $350 billion would be "not cost effective" and we should let the entire nation die. That is an absurd conclusion. It cannot be a linear scale. As the fraction of the population at risk goes up, what we are willing to do to avert it would go up without limit.
Title: Re: How long can we wait while flattening the curve?
Post by: Boofinator on March 25, 2020, 01:42:37 PM
The Imperial College London study estimated there would be 2.2 million deaths if this thing is unchecked.  Even if the number is a third of that, that's still more Americans than were killed in all of the wars of the 20th century. 

I'm starting to see a lot of scientific pushback on the Imperial College Study's projections.  Specifically, many scientists think they drastically over-estimate the R0 factor of asymptomatic people, the required hospitalization rate, and the exponential nature of the virus.

The Imperial College Study predicted a *minimum* of 1.1 million deaths EVEN IF (!!!) we did three months of strict suppression.  Will be interesting to see if that pans out.

Please enlighten us.

Here's the paragraph which mentions 1.1 million deaths:

Quote
Perhaps our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

What they are saying is clearly evident. If the disease were to spread throughout the population, and if we had enough infrastructure to properly care for everyone (which we don't), the U.S. would see at least 1.1 million people die (some 0.3% of the population). This shouldn't really be controversial.
Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate on March 25, 2020, 02:28:28 PM
I mean, suppose that we put the value of a life at $1 million. That would mean that if the entire nation was at risk of dying, let's say from an asteroid impact, any measures that cost more than $350 billion would be "not cost effective" and we should let the entire nation die. That is an absurd conclusion. It cannot be a linear scale. As the fraction of the population at risk goes up, what we are willing to do to avert it would go up without limit.

Your numbers are off by three orders of magnitude. There are about 330 million people in the USA, and if each one is worth a $1 million, that would be $330 trillion, or 15x annual GDP. Since we probably won't be able to spend that much, you're going to die in that scenario.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 25, 2020, 03:09:22 PM
I mean, suppose that we put the value of a life at $1 million. That would mean that if the entire nation was at risk of dying, let's say from an asteroid impact, any measures that cost more than $350 billion would be "not cost effective" and we should let the entire nation die. That is an absurd conclusion. It cannot be a linear scale. As the fraction of the population at risk goes up, what we are willing to do to avert it would go up without limit.

Your numbers are off by three orders of magnitude. There are about 330 million people in the USA, and if each one is worth a $1 million, that would be $330 trillion, or 15x annual GDP. Since we probably won't be able to spend that much, you're going to die in that scenario.

Yes and no. If we had 100 years of notice I bet that we would spend the money.
Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate on March 25, 2020, 04:11:00 PM
Yes and no. If we had 100 years of notice I bet that we would spend the money.

You don't think we'd dick around for 95 years and then try an make up for it in the last five? The Giant Asteroid deniers are a rather vocal bunch who would point out that there isn't scientific consensus on where the asteroid would hit, so we might as well do nothing.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 25, 2020, 04:35:00 PM
Yes and no. If we had 100 years of notice I bet that we would spend the money.

You don't think we'd dick around for 95 years and then try an make up for it in the last five? The Giant Asteroid deniers are a rather vocal bunch who would point out that there isn't scientific consensus on where the asteroid would hit, so we might as well do nothing.
Or: emerging and future technology will handle it. No need to waste time now, let future generations address the problem. We need a tax cut now!
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 25, 2020, 05:11:50 PM
I mean, suppose that we put the value of a life at $1 million. That would mean that if the entire nation was at risk of dying, let's say from an asteroid impact, any measures that cost more than $350 billion would be "not cost effective" and we should let the entire nation die. That is an absurd conclusion. It cannot be a linear scale. As the fraction of the population at risk goes up, what we are willing to do to avert it would go up without limit.

Your numbers are off by three orders of magnitude. There are about 330 million people in the USA, and if each one is worth a $1 million, that would be $330 trillion, or 15x annual GDP. Since we probably won't be able to spend that much, you're going to die in that scenario.
Oops, thanks!

We don't have to spend it all at once though.
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on March 25, 2020, 06:33:21 PM
I mean, suppose that we put the value of a life at $1 million. That would mean that if the entire nation was at risk of dying, let's say from an asteroid impact, any measures that cost more than $350 billion would be "not cost effective" and we should let the entire nation die. That is an absurd conclusion. It cannot be a linear scale. As the fraction of the population at risk goes up, what we are willing to do to avert it would go up without limit.

Your numbers are off by three orders of magnitude. There are about 330 million people in the USA, and if each one is worth a $1 million, that would be $330 trillion, or 15x annual GDP. Since we probably won't be able to spend that much, you're going to die in that scenario.

Yes and no. If we had 100 years of notice I bet that we would spend the money.

PDXTabs, I can't tell if you are being sarcastic or not. Why? Because of Climate Change.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 25, 2020, 07:33:20 PM
PDXTabs, I can't tell if you are being sarcastic or not. Why? Because of Climate Change.

I was being serious, but I understand the confusion.

Imagine if at 350 PPM of CO2 everyone died. I don't think that we would have ever gotten to 350 PPM. The problem with climate change is that you can always kick it off for one more year, one more PPM.
Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 25, 2020, 07:41:44 PM
Bloop, I run a small business and know lots of small business owners. You are just wrong about this. You can do a fantastic conscientious job and not pay yourself crazy money in many industries and still only be making 5-10%. That's just the reality. It is not a reflection on the owner of the business being bad at it or greedy.

Even if you're operating at an awesome margin, say 50% - if you have even half of your expenses as fixed ones (paying employees, insurance, rent for your space, etc) you'll go under pretty fast if revenue goes to zero suddenly. How much of your own money are you going to plow into paying rent on an empty restaurant every month? Better to close up shop and wait for better times - but that also means now your employees and landlord are SOL.

-W

I'm not disputing that this is how some industries work. I'm disputing whether such a business can be characterised as "very successful". If the business is constantly a few weeks from bankruptcy and has no fat on the bones, why bother running it? I've never understood why people bother going into retail/restaurants - I've looked at plenty of their profit/loss statements and none of them ever makes more than a tiny tiny margin. My conclusion is that people either do it for passion (and are willing to not be particularly financially successful) or they do it by taking cash receipts and not declaring them.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 08:24:15 PM
I'm not disputing that this is how some industries work. I'm disputing whether such a business can be characterised as "very successful". If the business is constantly a few weeks from bankruptcy and has no fat on the bones, why bother running it? I've never understood why people bother going into retail/restaurants - I've looked at plenty of their profit/loss statements and none of them ever makes more than a tiny tiny margin. My conclusion is that people either do it for passion (and are willing to not be particularly financially successful) or they do it by taking cash receipts and not declaring them.

Almost all industry is low margin. That's how capitalism works. If there's a lot of "fat on the bone", someone will undercut your price. Did you not think this through at all?

Most businesses do not carry many months/years of spare cash, though some can get along for a while by cutting costs/selling assets to some extent. There are certainly exceptions, but a complete drying up of revenue will kill pretty much any business on earth within 3-6 months, I'd say.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 25, 2020, 08:35:53 PM
I guess it depends on the industry. I work in legal services and our margins are incredibly fat. I run a small practice and my annual fixed costs are only something like $35k all up. That's $3k a month. I don't employ any employees directly - just occasional contractors, and they come cheap-ish. I could operate for many months just on a preceding month's income. Most professional services industries would have a similarly gigantic margin. This is why I think if you're going to go into business, you either pick a high-margin area (essentially white collar, or some other sheltered industry) or you generate profits through franchising or large scale, e.g. manufacturing. Stuff in the middle - restaurants, cafes, mechanics - which have neither massive scale nor high margins makes it very hard to sustain yourself, and hard to get rich.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 08:43:56 PM
Good for you. Hope you don't need any of those other businesses to hire you for legal work...

Again, I don't get what you're trying to say. It sounds like you think car mechanics, or restauranteurs (or airlines) are *bad people* or somehow unworthy because they don't have businesses that can run with no revenue for years at a time?

I mean, my total overhead for a YEAR is maybe $2500, I work from home and just need some insurance, and own all my equipment. But I'm not going to stand up and call out a successful mechanic whose 25 year old business put his kids through college a loser because he can't make payroll after a few months of no revenue.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 25, 2020, 08:53:32 PM
I never said anything of the sort - that they are losers, or bad people, or unworthy. Where did you pluck that phrasing from? And where did you get the notion that I said businesses should run with no revenue for years at a time? All these are things you are imputing to me, yet they are all straw men. You need to be very careful with what you impute to others' posts.

What I said, and what you should respond to, was that I queried whether they could be counted as "very successful" businesses if they shut down within a month of the good times tap being turned off.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 08:58:16 PM
What I said, and what you should respond to, was that I queried whether they could be counted as "very successful" businesses if they shut down within a month of the good times tap being turned off.

Ok, in that case, you think that something like 95% of all businesses aren't successful? Because, really, very few can survive even a short period of time with no revenue. Entire industries can't, so there can't be even one "successful" business in there?

I think you and I, while we call our outfits "businesses" are really just doing jobs for ourselves. If I had no revenue and had to keep paying an employee what I pay myself, I'd be out of business pretty fast too. How about you?

I think extrapolating your experience to the larger business world is probably not a great way to look at things. You and other highly educated self-employed people are not "businesses" in the same way that a restaurant is. That's great, for both of us, but our experience is an extreme outlier (which is heavily overrepresented on this forum).
-W
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 25, 2020, 08:59:47 PM
I guess it depends on the industry. I work in legal services and our margins are incredibly fat.
If margins are fat it's usually because there are large barriers of entry. If the sector is hard to enter, for example because you need a license (lawyers, doctors, etc) which means you need to plow down a chunk of capital, then people won't think it's worth it unless the margin is higher.
Title: Re: How long can we wait while flattening the curve?
Post by: Bloop Bloop on March 25, 2020, 09:09:54 PM
What I said, and what you should respond to, was that I queried whether they could be counted as "very successful" businesses if they shut down within a month of the good times tap being turned off.

Ok, in that case, you think that something like 95% of all businesses aren't successful? Because, really, very few can survive even a short period of time with no revenue. Entire industries can't, so there can't be even one "successful" business in there?

I think you and I, while we call our outfits "businesses" are really just doing jobs for ourselves. If I had no revenue and had to keep paying an employee what I pay myself, I'd be out of business pretty fast too. How about you?

I think extrapolating your experience to the larger business world is probably not a great way to look at things. You and other highly educated self-employed people are not "businesses" in the same way that a restaurant is. That's great, for both of us, but our experience is an extreme outlier (which is heavily overrepresented on this forum).
-W

Yes, I can agree with a lot of what you say. If I had to pay my profit to myself as employee wages, I'd be out of business very quickly. Of course, that's the whole point of going into business for yourself - so you can pay yourself the employee wage plus a fat slice of profit. If I paid myself only what I'd pay to a market employee I could survive for probably 9-15 months off residual inflows and then I'd have to shutter the business. And I know I speak from a position of privilege. By the same token, I think that if someone's owning, say, a restaurant, and isn't able to keep the restaurant functioning for even a month by taking out some of the owner's equity/profit (i.e. the fat they get from the operations of the business paid to themselves), then they are working on such razor thin margins (and profits) that they might as well have stayed an employee.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on March 25, 2020, 09:13:46 PM
Well, we're about to find out if anyone is going to hire a lawyer or a high end fabricator after they get laid off or close their restaurant...

-W
Title: Re: How long can we wait while flattening the curve?
Post by: Travis on March 25, 2020, 09:15:11 PM
I guess it depends on the industry. I work in legal services and our margins are incredibly fat. I run a small practice and my annual fixed costs are only something like $35k all up. That's $3k a month. I don't employ any employees directly - just occasional contractors, and they come cheap-ish. I could operate for many months just on a preceding month's income. Most professional services industries would have a similarly gigantic margin. This is why I think if you're going to go into business, you either pick a high-margin area (essentially white collar, or some other sheltered industry) or you generate profits through franchising or large scale, e.g. manufacturing. Stuff in the middle - restaurants, cafes, mechanics - which have neither massive scale nor high margins makes it very hard to sustain yourself, and hard to get rich.

I doubt most small business owners are looking to "get rich." This community is full of people who simply don't want to work for somebody else.  Should we all just resign ourselves to depending on MegaCorp for our income since they're the only ones able to weather a storm like this?  Congratulations on being in an industry that has no need for inventory, facilities, labor, or apparently enough competition to affect the prices you can demand.  Most other businesses in the world don't operate like that.  In fact, when they're sitting on that much cash the public howls wondering why they aren't lowering prices or hiring more labor.  Stockholders ask why they aren't reinvesting in themselves to become even more profitable.  Small businesses spend their first couple years in debt.  A third of small businesses don't survive their first two years. Half don't make it past five years.  If they make it that far, I would consider them successful. Also, they are "successful" relative to their own industry.  If an entire industry is in such competition that 5% profit puts them at the top of the ladder, then they're very successful. 
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 26, 2020, 09:45:35 AM
This was a really good article about what lies on the other side of the lockdowns and why a hard lockdown is a preferable strategy to a half-assed flattening of the curve: https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56 (https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56).

I'm thinking Trump may fully realize that ongoing soft social distancing will cause more aggregate damage in the long run, but prefer it because that damage is disproportionately borne by the Democratic base.  A full lockdown would spread the pain much more in the direction of his base.

Anecdote, which is not the singular of data: Yesterday I drove from my urban core out about 90 minutes into the countryside.  The heavily Democratic city is basically shut down.  The people who aren't getting paid are disproportionately young, and/or black, and/or brown.  The entire area is composed of safe D districts, but the economic damage is most focused even there/here within the D base.

Once I hit the ex-urbs, and certainly out in the rural areas, it looked like business as usual.  Parking lots were full, roads full of traffic.  This is also a hard core Trump district.

It doesn't seem far fetched to imagine that this dynamic is playing out around the country, with urban, Democratic areas bearing most of the burden for social distancing, and rural, Trump areas basically going on as usual.

If I were Trump, with not only a base to please but also professed malice for Democrats, cities, and brown people, I can see why drawing out the pain and concentrating it in cities is far preferable to locking everything down so that it also impacts ex-urban and rural areas.
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on March 26, 2020, 09:58:31 AM
This was a really good article about what lies on the other side of the lockdowns and why a hard lockdown is a preferable strategy to a half-assed flattening of the curve: https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56 (https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56).

I'm thinking Trump may fully realize that ongoing soft social distancing will cause more aggregate damage in the long run, but prefer it because that damage is disproportionately borne by the Democratic base.  A full lockdown would spread the pain much more in the direction of his base.

Anecdote, which is not the singular of data: Yesterday I drove from my urban core out about 90 minutes into the countryside.  The heavily Democratic city is basically shut down.  The people who aren't getting paid are disproportionately young, and/or black, and/or brown.  The entire area is composed of safe D districts, but the economic damage is most focused even there/here within the D base.

Once I hit the ex-urbs, and certainly out in the rural areas, it looked like business as usual.  Parking lots were full, roads full of traffic.  This is also a hard core Trump district.

It doesn't seem far fetched to imagine that this dynamic is playing out around the country, with urban, Democratic areas bearing most of the burden for social distancing, and rural, Trump areas basically going on as usual.

If I were Trump, with not only a base to please but also professed malice for Democrats, cities, and brown people, I can see why drawing out the pain and concentrating it in cities is far preferable to locking everything down so that it also impacts ex-urban and rural areas.

That suggests that he will only change his tune once rural folks start dying in droves. We will see how this plays out, unfortunately.
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 26, 2020, 10:05:58 AM
That suggests that he will only change his tune once rural folks start dying in droves. We will see how this plays out, unfortunately.

And in the meanwhile, he'll continue to write everyone $1200 checks to buy their support, even if their employment hasn't been impacted.  I guess we'll see if he can keep it up for the next eight months.

Once things do go south in the rural areas, cities will be faced with a choice of either bailing out the rural health care system, or transporting all of those sick people into the cities for treatment.

I agree with those who say there are really only two reasonable approaches.  Either we call out the Army and shut society down for a couple weeks, or we let the virus run and mitigate where we can.  The in-between approach that we're trying isn't going to work, and the distribution of the burden is deeply unfair.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 26, 2020, 10:22:00 AM


I'm thinking Trump may fully realize that ongoing soft social distancing will cause more aggregate damage in the long run, but prefer it because that damage is disproportionately borne by the Democratic base.  A full lockdown would spread the pain much more in the direction of his base.

That's a bold prediction (that it will disproportionately be borne by the Democratic base).  Two reasons to suspect it might not be that way:

Seattle and NYC have been epicenters thus far, but I'd bet dollars to donuts we'll see a lot more cases in more red and rural districts in the weeks to come.  I live in one such district and up until Tuesday coffee shops, daycare centers and bars were still open. People here are more likely to describe the entire thing as a 'hoax' or an overreaction.  Now a handful of new cases have been reported in our town (gee, go figure...)

The thing about urban vs rural areas is that the economies of urban centers have a relience because there are so many people and so much diversity (both in terms of people and job skills.  In rural areas that closing of a single business or sometimes the death of a single person can seriously disrupt everyone's lives.
Likewise, the group that supports Trump the most have always been white men 65 and older.  I postulate that will be one of the demographics hit the hardest by early summer.
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 26, 2020, 10:24:12 AM
That suggests that he will only change his tune once rural folks start dying in droves. We will see how this plays out, unfortunately.

I should so add that events in rural areas no longer drive the news in rural areas.  Local reporting has been so thoroughly gutted that if a small town had an outbreak, there'd be nobody to cover it, and no paper to publish it.  The outbreak would just be a series of isolated incidents without any aggregation or interpretation.

Part of the "beauty" of Trumpworld is that it's informed by a Fox news narrative that isn't actually about its audience, it's about those other people (celebrities, urbanites, violent criminals, sociopathic mothers, national politicians, college students).  It's not like there's any danger of Fox sending a reporter out to a small town in rural Kansas where the hospital system is on the verge of collapse to do a deep dive into what life is like there.  The local realities no longer matter much.  What matters is the fully nationalized news narrative.
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 26, 2020, 10:28:29 AM

Seattle and NYC have been epicenters thus far, but I'd bet dollars to donuts we'll see a lot more cases in more red and rural districts in the weeks to come.  I live in one such district and up until Tuesday coffee shops, daycare centers and bars were still open. People here are more likely to describe the entire thing as a 'hoax' or an overreaction.  Now a handful of new cases have been reported in our town (gee, go figure...)

The thing about urban vs rural areas is that the economies of urban centers have a relience because there are so many people and so much diversity (both in terms of people and job skills.  In rural areas that closing of a single business or sometimes the death of a single person can seriously disrupt everyone's lives.
Likewise, the group that supports Trump the most have always been white men 65 and older.  I postulate that will be one of the demographics hit the hardest by early summer.

All good and fair points.  I should clarify that when I say "in the long run," what I mean is between now and election day.  I think it's altogether possible that over the full course of this illness, older rural voters end up hit hard.  The political question is partly whether that pain can be delayed past the next election.

The other part of the political question is the reporting question that I just mentioned above.  Not to be too glib, but if a bunch of white men over 65 in a rural area die and Fox news doesn't report it, did it really happen?
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 26, 2020, 10:30:52 AM
The Imperial College London study estimated there would be 2.2 million deaths if this thing is unchecked.  Even if the number is a third of that, that's still more Americans than were killed in all of the wars of the 20th century. 

I'm starting to see a lot of scientific pushback on the Imperial College Study's projections.  Specifically, many scientists think they drastically over-estimate the R0 factor of asymptomatic people, the required hospitalization rate, and the exponential nature of the virus.

The Imperial College Study predicted a *minimum* of 1.1 million deaths EVEN IF (!!!) we did three months of strict suppression.  Will be interesting to see if that pans out.

Please enlighten us.

Here's the paragraph which mentions 1.1 million deaths:

Quote
Perhaps our most significant conclusion is that mitigation is unlikely to be feasible without emergency surge capacity limits of the UK and US healthcare systems being exceeded many times over. In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

What they are saying is clearly evident. If the disease were to spread throughout the population, and if we had enough infrastructure to properly care for everyone (which we don't), the U.S. would see at least 1.1 million people die (some 0.3% of the population). This shouldn't really be controversial.

I honestly might be reading this wrong, but isn't that study saying even if we took the "most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly)," we would still see 1.1M deaths? 

FWIW, the author of that same Imperial College Study, who predicted 500K deaths in the UK even with stringent mitigation strategies, now predicts 20K deaths: https://www.newscientist.com/article/2238578-uk-has-enough-intensive-care-units-for-coronavirus-expert-predicts/

Translating that to the US, we are looking at maybe 40-50k deaths.  Still terrible but way less than what would be a catastrophic event.
Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on March 26, 2020, 10:35:39 AM
Hope that's right @ReadySetMillionaire. Basically just an extra year's worth of traffic accident deaths - darn Sunday drivers!

I think it is awfully early though, and if we stop social distancing prematurely things probably look a whole lot different.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 26, 2020, 10:40:35 AM

Seattle and NYC have been epicenters thus far, but I'd bet dollars to donuts we'll see a lot more cases in more red and rural districts in the weeks to come.  I live in one such district and up until Tuesday coffee shops, daycare centers and bars were still open. People here are more likely to describe the entire thing as a 'hoax' or an overreaction.  Now a handful of new cases have been reported in our town (gee, go figure...)

The thing about urban vs rural areas is that the economies of urban centers have a relience because there are so many people and so much diversity (both in terms of people and job skills.  In rural areas that closing of a single business or sometimes the death of a single person can seriously disrupt everyone's lives.
Likewise, the group that supports Trump the most have always been white men 65 and older.  I postulate that will be one of the demographics hit the hardest by early summer.

All good and fair points.  I should clarify that when I say "in the long run," what I mean is between now and election day.  I think it's altogether possible that over the full course of this illness, older rural voters end up hit hard.  The political question is partly whether that pain can be delayed past the next election.


The rate of spread of this disease suggests to me that these populations will be hard hit in the next month, far before the November election.  I think these areas (my own included) are kidding themselves to think that low population density will spare them (it hasn't for other respiratory outbreaks).  To that end, WaPo has some interesting comments from their reporting:
Americans have died in 42 states and territories and the District, with punishing increases in Louisiana and Michigan. Experts fear the worst is still to come, pointing to a rapid acceleration of cases in communities across the country...
About 65 percent of people whose ages are known were older than 70 and nearly 40 percent were over 80, a risk that rises along with age...
Dense urban centers, many of them in coastal states, have been hardest hit in the first two months of the outbreak, but it’s only a matter of time before the coronavirus takes hold in rural areas, too. In some places, like Albany, Ga., where at least 12 have died, it’s already happening. When it arrives elsewhere, it could have a crippling effect, especially in places where resources and health-care workers are already in short supply.

Whether these deaths go unnoticed due to underreporting is an interesting question.  I suppose they probably will to a point - but if you are in that demographic and you lose some of your close friends... it's hard not to notice, even if it was never in the papers.  These people also have children and grandchildren that are certain to notice.
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 26, 2020, 10:58:04 AM

Whether these deaths go unnoticed due to underreporting is an interesting question.  I suppose they probably will to a point - but if you are in that demographic and you lose some of your close friends... it's hard not to notice, even if it was never in the papers.  These people also have children and grandchildren that are certain to notice.

For sure, but part of what good journalism does is aggregate individual experiences to reveal trends, and then interpret those trends to show what they mean.

It's one thing to go to a couple funerals of people you know.  It's a whole other thing when those funerals are put into a larger framework of causation, particularly government policy.  That sort of journalism transforms individual hardship into a political problem.
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on March 26, 2020, 11:02:14 AM
This was a really good article about what lies on the other side of the lockdowns and why a hard lockdown is a preferable strategy to a half-assed flattening of the curve: https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56 (https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56).

I'm thinking Trump may fully realize that ongoing soft social distancing will cause more aggregate damage in the long run, but prefer it because that damage is disproportionately borne by the Democratic base.  A full lockdown would spread the pain much more in the direction of his base.

Anecdote, which is not the singular of data: Yesterday I drove from my urban core out about 90 minutes into the countryside.  The heavily Democratic city is basically shut down.  The people who aren't getting paid are disproportionately young, and/or black, and/or brown.  The entire area is composed of safe D districts, but the economic damage is most focused even there/here within the D base.

Once I hit the ex-urbs, and certainly out in the rural areas, it looked like business as usual.  Parking lots were full, roads full of traffic.  This is also a hard core Trump district.

It doesn't seem far fetched to imagine that this dynamic is playing out around the country, with urban, Democratic areas bearing most of the burden for social distancing, and rural, Trump areas basically going on as usual.

If I were Trump, with not only a base to please but also professed malice for Democrats, cities, and brown people, I can see why drawing out the pain and concentrating it in cities is far preferable to locking everything down so that it also impacts ex-urban and rural areas.

Viewpoints like this make me realize how fucked we are as a society. We're facing a pandemic, and have an opportunity to come together for the common good and yet peoples first reaction is to look for a way to criticize the other side of the aisle. I think you're giving Trump WAY too much credit here.
I think the reason you see more activity in rural areas has more to do with the type of people that tend to live there (raises hand), the fact that you often have to use a vehicle to do anything (car culture), and the fact that rural areas really haven't been hit hard yet in the US, or anywhere else.
The virus has impacted densely populated areas with worse air quality the most. You also get the most bang for your "shelter-in-place" buck in those same densely populated areas compared to a rural area.

For what it's worth, my very red part of a very red state has been pretty much closed up for over a week now. Schools have been out for nearly two weeks and will remain closed until atleast May. The local college is empty and all online instruction. Gyms, salons, and most of the large retailers that don't sell food are closed. People are out and about, but traffic is noticeably lighter and the only places with cars in the parking lots are "essential" businesses.
I'd guess what you might see in a more urban area reflects the income disparity, where low wage hourly workers currently have no jobs to go to, while higher earners are salaried and able to work from home.
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 26, 2020, 11:08:44 AM
Viewpoints like this make me realize how fucked we are as a society. We're facing a pandemic, and have an opportunity to come together for the common good and yet peoples first reaction is to look for a way to criticize the other side of the aisle. I think you're giving Trump WAY too much credit here.

Trump has spent four-plus years undercutting any sense of a shared society.  It's been us-versus-them from day one.  He doesn't get to magically recover what Dewey called the Great Society when he needs it and when it suits his political purposes.
Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on March 26, 2020, 11:30:58 AM
Can we give the political dialogue a rest already?


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Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 26, 2020, 11:34:34 AM
Can we give the political dialogue a rest already?


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I'm not sure what the non-political version of a thread about trading off deaths for economic activity would be.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 26, 2020, 11:54:34 AM

Due to the lack of testing, we are flying blind with this outbreak. More Tests Equal More Confirmed Cases. Less confirmed cases does not mean less cases!

New York is leading the nation in the number of Covid cases. It has also conducted more Covid tests, with over 100,000 completed, even though New York is only the fourth largest state with a population of 19.4 million. Florida has a population of 20 million but has only conducted 16,000 tests while California, the largest state with a population of 40 million, has only conducted 28,000 tests.

Until there is more widespread Covid testing, it will be difficult to come to any conclusion as to whether the pandemic is affecting new york more than south dakota. There is also a cultural trust issue with healthcare whereby people in rural areas may be less likely to seek medical care and get tested, this was reported on NPR this morning.

COVID doesn't care whether you're a democrat or a republican.



Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on March 26, 2020, 12:14:39 PM
We're up to 28,000 tests in Florida. Around 1400 pending results, and about 10% positive, 90% negative of those that have come in. Still a relatively small number of tests, but testing is ramping up now.

But yes, you need really good testing efforts to asses the current situation, and then to play whack-a-mole effectively once things can get more back to normal.
Title: How long can we wait while flattening the curve?
Post by: the_fixer on March 26, 2020, 12:16:29 PM
This was a really good article about what lies on the other side of the lockdowns and why a hard lockdown is a preferable strategy to a half-assed flattening of the curve: https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56 (https://www.google.com/url?q=https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56).

I'm thinking Trump may fully realize that ongoing soft social distancing will cause more aggregate damage in the long run, but prefer it because that damage is disproportionately borne by the Democratic base.  A full lockdown would spread the pain much more in the direction of his base.

Anecdote, which is not the singular of data: Yesterday I drove from my urban core out about 90 minutes into the countryside.  The heavily Democratic city is basically shut down.  The people who aren't getting paid are disproportionately young, and/or black, and/or brown.  The entire area is composed of safe D districts, but the economic damage is most focused even there/here within the D base.

Once I hit the ex-urbs, and certainly out in the rural areas, it looked like business as usual.  Parking lots were full, roads full of traffic.  This is also a hard core Trump district.

It doesn't seem far fetched to imagine that this dynamic is playing out around the country, with urban, Democratic areas bearing most of the burden for social distancing, and rural, Trump areas basically going on as usual.

If I were Trump, with not only a base to please but also professed malice for Democrats, cities, and brown people, I can see why drawing out the pain and concentrating it in cities is far preferable to locking everything down so that it also impacts ex-urban and rural areas.

That suggests that he will only change his tune once rural folks start dying in droves. We will see how this plays out, unfortunately.

I should so add that events in rural areas no longer drive the news in rural areas.  Local reporting has been so thoroughly gutted that if a small town had an outbreak, there'd be nobody to cover it, and no paper to publish it.  The outbreak would just be a series of isolated incidents without any aggregation or interpretation.

Part of the "beauty" of Trumpworld is that it's informed by a Fox news narrative that isn't actually about its audience, it's about those other people (celebrities, urbanites, violent criminals, sociopathic mothers, national politicians, college students).  It's not like there's any danger of Fox sending a reporter out to a small town in rural Kansas where the hospital system is on the verge of collapse to do a deep dive into what life is like there.  The local realities no longer matter much.  What matters is the fully nationalized news narrative.
Can we give the political dialogue a rest already?


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I'm not sure what the non-political version of a thread about trading off deaths for economic activity would be.

Ugggh so freaking tired of informative thoughtful threads being closed or destroyed by people coming in and trying to pin everything on trump, Republicans or whatever  party no different that the stupidity around the Obama birth certificate and whatever people decide to latch onto when a party they do not like is in office.

I get it you are not a fan of trump like most of us here but can we actually have a freaking discussion without saying stupid shit like trumpworld and trying to make the conversation partisan / inflammatory?

Maybe go back to the off topic area if you want to bitch about that stuff


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Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on March 26, 2020, 12:24:31 PM

Due to the lack of testing, we are flying blind with this outbreak. More Tests Equal More Confirmed Cases. Less confirmed cases does not mean less cases!
Deaths are deaths, though, they're a bit harder to hide: https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html (https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html)
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 26, 2020, 12:30:17 PM

Due to the lack of testing, we are flying blind with this outbreak. More Tests Equal More Confirmed Cases. Less confirmed cases does not mean less cases!
Deaths are deaths, though, they're a bit harder to hide: https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html (https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html)

yeah but to be useful number of deaths reallly needs to be normalized. its not useful to compare number of deaths in us (350m people) to italy (60m people).

also, are we really testing everyone that dies with covid symptoms? without a test, cause of death could be pneumonia, heart failure or something else. when tests are so limited why waste a test on someone that is dead or going to die anyway? especially when that test could be used to test a health care worker or someone who lived in a group setting, potentially infecting many others.

Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on March 26, 2020, 12:32:51 PM

Due to the lack of testing, we are flying blind with this outbreak. More Tests Equal More Confirmed Cases. Less confirmed cases does not mean less cases!
Deaths are deaths, though, they're a bit harder to hide: https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html (https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html)

yeah but to be useful number of deaths reallly needs to be normalized. its not useful to compare number of deaths in us (350m people) to italy (60m people).

also, are we really testing everyone that dies with covid symptoms? without a test, cause of death could be pneumonia, heart failure or something else. when tests are so limited why waste a test on someone that is dead or going to die anyway? especially when that test could be used to test a health care worker or someone who lived in a group setting, potentially infecting many others.

Are all corpses tested for coronavirus?  If they're not, you might not know the real numbers.
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on March 26, 2020, 12:44:16 PM
"Translating that to the US, we are looking at maybe 40-50k deaths.  Still terrible but way less than what would be a catastrophic event."
----------------------------------------------------------------------------------------------------

I hope you and the Imperial Study are right, Millionaire

*USA has 1000 total deaths as of today (75 deaths per day at this time), and assuming EVERYONE is 100% serious about social distancing beginning today, we will have about 15 days of additional exponential positive infection tests [the infections themselves have mostly already occurred, they just haven't been diagnosed or counted], with corresponding 15 days of additional exponential deaths. There will be a 6-9 day delay between diagnosis and death for the unlucky. This also assumes we don't overwhelm the medical system. Lots of assumptions here, I know. All these assumptions are conservative.

So infections are at 75K in USA today, will double 5 times before they decrease their rate of growth, and hopefully turn the corner after that. At exponential peak, we will have 2,400,000 infected.

This leads to 75 deaths per day doubling 5 times, or 4650 new deaths by end of April 10th, total of 5650 deaths by Good Friday. Add the 6-9 day delay from diagnosis till death and we will have 20050 deaths total in 3 weeks. Reverse it for an additional 20050 assuming no new infections from then on, and we will have 40100 deaths in 6 weeks.

I am not at all certain about my numbers above, please check my math.

The tighter the control of spread FROM TODAY ON, the closer the results will be to the math. The looser the control of spread, and that number will only be higher.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 26, 2020, 12:51:03 PM

Due to the lack of testing, we are flying blind with this outbreak. More Tests Equal More Confirmed Cases. Less confirmed cases does not mean less cases!
Deaths are deaths, though, they're a bit harder to hide: https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html (https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html)


yeah but to be useful number of deaths reallly needs to be normalized. its not useful to compare number of deaths in us (350m people) to italy (60m people).

also, are we really testing everyone that dies with covid symptoms? without a test, cause of death could be pneumonia, heart failure or something else. when tests are so limited why waste a test on someone that is dead or going to die anyway? especially when that test could be used to test a health care worker or someone who lived in a group setting, potentially infecting many others.

Are all corpses tested for coronavirus?  If they're not, you might not know the real numbers.

https://www.buzzfeednews.com/article/nidhiprakash/coronavirus-update-dead-covid19-doctors-hospitals
Title: Re: How long can we wait while flattening the curve?
Post by: Boofinator on March 26, 2020, 12:57:40 PM
Maybe go back to the off topic area if you want to bitch about that stuff

The 100-post minimum in the Off-Topic has simply spread the nonsense around to the rest of the forum. I'd say at least half the topics that are covering coronavirus belong in Off-Topic, including this one.
Title: Re: How long can we wait while flattening the curve?
Post by: Boofinator on March 26, 2020, 01:02:46 PM
Maybe go back to the off topic area if you want to bitch about that stuff

The 100-post minimum in the Off-Topic has simply spread the nonsense around to the rest of the forum. I'd say at least half the topics that are covering coronavirus belong in Off-Topic, including this one.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on March 26, 2020, 01:30:58 PM
"Translating that to the US, we are looking at maybe 40-50k deaths.  Still terrible but way less than what would be a catastrophic event."
----------------------------------------------------------------------------------------------------

I hope you and the Imperial Study are right, Millionaire

*USA has 1000 total deaths as of today (75 deaths per day at this time), and assuming folks in outlying areas are completely serious about social distancing beginning today, we will have about 15 days of additional exponential positive infection tests [the infections themselves have mostly already occurred, they just haven't been diagnosed or counted], with corresponding 15 days of additional exponential deaths. There will be a 6-9 day delay between diagnosis and death for the unlucky. This also assumes we don't overwhelm the medical system. Lots of assumptions here, I know. All these assumptions are conservative.

So infections are at 75K in USA today, will double 5 times before they decrease their rate of growth, and hopefully turn the corner after that. At exponential peak, we will have 2,400,000 infected.

This leads to 75 deaths per day doubling 5 times, or 4650 new deaths by end of April 10th, total of 5650 deaths by Good Friday. Add the 6-9 day delay from diagnosis till death and we will have 20050 deaths total in 3 weeks. Reverse it for an additional 20050 assuming no new infections from then on, and we will have 40100 deaths in 6 weeks.

I am not at all certain about my numbers above, please check my math.

The tighter the control of spread FROM TODAY ON, the closer the results will be to the math. The looser the control of spread, and that number will only be higher.

Why is the assumption that people outside of heavily infected areas have been resuming life as normal until today?
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on March 26, 2020, 01:32:29 PM

Due to the lack of testing, we are flying blind with this outbreak. More Tests Equal More Confirmed Cases. Less confirmed cases does not mean less cases!
Deaths are deaths, though, they're a bit harder to hide: https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html (https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html)


yeah but to be useful number of deaths reallly needs to be normalized. its not useful to compare number of deaths in us (350m people) to italy (60m people).

also, are we really testing everyone that dies with covid symptoms? without a test, cause of death could be pneumonia, heart failure or something else. when tests are so limited why waste a test on someone that is dead or going to die anyway? especially when that test could be used to test a health care worker or someone who lived in a group setting, potentially infecting many others.

Are all corpses tested for coronavirus?  If they're not, you might not know the real numbers.

https://www.buzzfeednews.com/article/nidhiprakash/coronavirus-update-dead-covid19-doctors-hospitals


Ah.  So the answer to my question is a big screaming "HELLZ NO!" then.  The US is under reporting deaths from the virus.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 26, 2020, 01:37:41 PM
Maybe go back to the off topic area if you want to bitch about that stuff

The 100-post minimum in the Off-Topic has simply spread the nonsense around to the rest of the forum. I'd say at least half the topics that are covering coronavirus belong in Off-Topic, including this one.
Nah. Most threads on here have devolved after 4-5 pages into politics and camps. This was true long before the 100 post off-topic minimum.

There’s even an Internet “rule” about such tendencies on forums.

Who’s going to bring up Hitler now?
Title: Re: How long can we wait while flattening the curve?
Post by: frugalnacho on March 26, 2020, 01:41:32 PM
Maybe go back to the off topic area if you want to bitch about that stuff

The 100-post minimum in the Off-Topic has simply spread the nonsense around to the rest of the forum. I'd say at least half the topics that are covering coronavirus belong in Off-Topic, including this one.
Nah. Most threads on here have devolved after 4-5 pages into politics and camps. This was true long before the 100 post off-topic minimum.

There’s even an Internet “rule” about such tendencies on forums.

Who’s going to bring up Hitler now?

Rule 34? Hitler porn? It exists.  Trust me.
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on March 26, 2020, 02:06:39 PM
Viewpoints like this make me realize how fucked we are as a society. We're facing a pandemic, and have an opportunity to come together for the common good and yet peoples first reaction is to look for a way to criticize the other side of the aisle. I think you're giving Trump WAY too much credit here.

Trump has spent four-plus years undercutting any sense of a shared society.  It's been us-versus-them from day one.  He doesn't get to magically recover what Dewey called the Great Society when he needs it and when it suits his political purposes.

There you go again, immediately blaming the other side. Its not anybody else's fault that you immediately viewed this as a "red vs blue" issue. Partisan politics and "us vs them" thinking started long before 2016, and I would argue, it's a large part of why Trump is unfortunately in the White House to begin with. As another poster pointed out, COVID doesn't care who you vote for. Most of this thread has done a good job of discussing something that tangentially relates to politics without devolving into partisan debates that just enflame things. There are more appropriate places here and elsewhere on the Internet to complain about leadership.
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on March 26, 2020, 02:10:41 PM
Why is the assumption that people outside of heavily infected areas have been resuming life as normal until today?
[/quote]

You are correct. Edited.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 26, 2020, 02:14:06 PM
As another poster pointed out, COVID doesn't care who you vote for.

You are right. I would further argue that public health response in a time of pandemic is not a red vs blue issue. It is however a competent vs incompetent issue. This isn't the George HW Bush administration, and the response has been incompetent at best.
Title: Re: How long can we wait while flattening the curve?
Post by: Davnasty on March 26, 2020, 03:22:11 PM
The Imperial College London study estimated there would be 2.2 million deaths if this thing is unchecked.  Even if the number is a third of that, that's still more Americans than were killed in all of the wars of the 20th century. 

I'm starting to see a lot of scientific pushback on the Imperial College Study's projections.  Specifically, many scientists think they drastically over-estimate the R0 factor of asymptomatic people, the required hospitalization rate, and the exponential nature of the virus.

The Imperial College Study predicted a *minimum* of 1.1 million deaths EVEN IF (!!!) we did three months of strict suppression.  Will be interesting to see if that pans out.

The prediction of 1.1 million deaths was based on a mitigation strategy which means targeted interventions including case isolation, household quarantine and social distancing of the elderly.

Neither the UK or the US is still pursuing a mitigation strategy, they've opted for suppression. That's what we're doing right now.

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

Quote
Two fundamental strategies are possible:
(a) Suppression. Here  the  aim  is to  reduce  the  reproduction  number  (the  average  number  of secondary cases each case generates), R, to below 1and hence to reduce case numbers to low levels or  (as  for  SARS  or  Ebola)  eliminate  human-to-human  transmission. The  main  challenge  of  this approach is that NPIs (and drugs, if available) need to be maintained –at least intermittently-for as long as the virus is circulating in the human population, or until a vaccine becomes available. In the case of COVID-19, it will be at least a 12-18 months before a vaccine is available. Furthermore,there is no guarantee that initial vaccines will have high efficacy.
(b) Mitigation. Here  the aim is to  use  NPIs  (and vaccines  or  drugs,  if  available)  not  to interrupt transmission completely, but to reduce the health impact of an epidemic, akin to the strategy adopted by  some  US  cities  in  1918,  and  by  the  world  more  generally  in  the  1957,  1968  and  2009  influenza pandemics. In the 2009 pandemic, for instance, early supplies of vaccine were targeted at individuals with pre-existing medical conditions which put them at risk of more severe disease. In this scenario, population  immunity  builds  up  through  the  epidemic,  leading  to  an  eventual  rapid  decline  in  case numbers and transmission dropping to low levels.
Title: Re: How long can we wait while flattening the curve?
Post by: caleb on March 26, 2020, 10:11:08 PM

Ugggh so freaking tired of informative thoughtful threads being closed or destroyed by people coming in and trying to pin everything on trump, Republicans or whatever  party no different that the stupidity around the Obama birth certificate and whatever people decide to latch onto when a party they do not like is in office.

I get it you are not a fan of trump like most of us here but can we actually have a freaking discussion without saying stupid shit like trumpworld and trying to make the conversation partisan / inflammatory?

Maybe go back to the off topic area if you want to bitch about that stuff

And, I am very tired of technocratic language being used to provide cover for essentially political choices.

Any question that is about who gets what/when/where/why/how is political.

Ascribing partisan causes to that does not change it.

Pretending that it is not political is to participate in a charade.  Carry on, if you wish.
Title: Re: How long can we wait while flattening the curve?
Post by: cerat0n1a on March 27, 2020, 06:24:08 AM
Anecdote, which is not the singular of data:

Love that phrase.
Title: Re: How long can we wait while flattening the curve?
Post by: Jon Bon on March 28, 2020, 06:38:01 AM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 28, 2020, 08:13:34 AM
If you need a laugh right now, watch this.

https://twitter.com/kenolin1/status/1242852430582341639?s=20
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on March 28, 2020, 08:20:19 AM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

Fascinating website.  Thanks for posting.
Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on March 28, 2020, 08:30:22 AM
If you need a laugh right now, watch this.

https://twitter.com/kenolin1/status/1242852430582341639?s=20
Thanks for the laugh, my wife and I were in tears we were laughing so hard.


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Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 28, 2020, 08:31:19 AM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

Fascinating website.  Thanks for posting.

The interesting thing about this is that it's way, way off what our governor and health director are saying (Ohio).

DeWine and Dr. Acton are using models that show that Ohio's surge won't come until mid-May, while this shows our surge in a couple weeks.

Regardless of policy position, we can only hope that the surge and low death numbers from the linked model here are correct.
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on March 28, 2020, 08:56:24 AM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

Fascinating website.  Thanks for posting.

The interesting thing about this is that it's way, way off what our governor and health director are saying (Ohio).

DeWine and Dr. Acton are using models that show that Ohio's surge won't come until mid-May, while this shows our surge in a couple weeks.

Regardless of policy position, we can only hope that the surge and low death numbers from the linked model here are correct.

If you look in the methodology, for the study they're assuming that effective social distancing will be immediately enacted by everyone in the US.  This seems to be  a somewhat idealistic view to me but hopefully they're right.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on March 28, 2020, 08:57:53 AM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

Fascinating website.  Thanks for posting.

The interesting thing about this is that it's way, way off what our governor and health director are saying (Ohio).

DeWine and Dr. Acton are using models that show that Ohio's surge won't come until mid-May, while this shows our surge in a couple weeks.

Regardless of policy position, we can only hope that the surge and low death numbers from the linked model here are correct.

If you look in the methodology, for the study they're assuming that effective social distancing will be immediately enacted by everyone in the US.  This seems to be  a somewhat idealistic view to me but hopefully they're right.

Polls in Ohio are showing that somewhere between 85-90% are practicing social distancing. That's pretty darn good.  It will be interesting to see how much that prolongs. 
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 28, 2020, 09:03:56 AM
Interesting bit on NPR about the effects of quarantined during the 1918 pandemic. As expected cities which took more comprehensive measures had far fewer deaths, but what was surprising was that these same cities did better economically over the following year.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on March 28, 2020, 09:53:01 AM

If you look in the methodology, for the study they're assuming that effective social distancing will be immediately enacted by everyone in the US.  This seems to be  a somewhat idealistic view to me but hopefully they're right.

I can only speak to what I see personally, but I think the social distancing and staying at home is very widespread at this point. I'm not out and about and talking to people for obvious reasons.  But what I've observed is people taking this seriously.  I'm also using my wildlife test.  Which is admittedly weird, but seems to work.  What are the critters doing?  Well, our urban wildlife has been out and about to a remarkable extent.  Foxes are trotting about in my neighborhood at mid-day with nary a care in the world.  The large birds are out in force, including the predators.  There was an article yesterday showing coyotes that are chilling out during the day in San Francisco.  Critters generally avoid people. 
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on March 28, 2020, 09:59:12 AM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

Fascinating website.  Thanks for posting.

The interesting thing about this is that it's way, way off what our governor and health director are saying (Ohio).

DeWine and Dr. Acton are using models that show that Ohio's surge won't come until mid-May, while this shows our surge in a couple weeks.

Regardless of policy position, we can only hope that the surge and low death numbers from the linked model here are correct.

If you look in the methodology, for the study they're assuming that effective social distancing will be immediately enacted by everyone in the US.  This seems to be  a somewhat idealistic view to me but hopefully they're right.

Polls in Ohio are showing that somewhere between 85-90% are practicing social distancing. That's pretty darn good.  It will be interesting to see how much that prolongs.

Polls may say that, but if they don't hang out in large groups, they probably consider themselves to be social distancing, despite frequently being closer than 6' to co-workers and others.  I know I'm still seeing people getting right next to each other where I work.  It's not easy to stay away from the people who suddenly come right up on you or when stuck in a meeting with them with no place to retreat to.
Title: Re: How long can we wait while flattening the curve?
Post by: skp on March 28, 2020, 10:19:03 AM
 

The interesting thing about this is that it's way, way off what our governor and health director are saying (Ohio).

DeWine and Dr. Acton are using models that show that Ohio's surge won't come until mid-May, while this shows our surge in a couple weeks.

Regardless of policy position, we can only hope that the surge and low death numbers from the linked model here are correct.
[/quote]


Polls in Ohio are showing that somewhere between 85-90% are practicing social distancing. That's pretty darn good.  It will be interesting to see how much that prolongs.
[/quote]

I live in Ohio.  Anecdotal evidence yes, but, I think people just like to think they are doing what they are suppose to be doing.  Who wants to admit they are exhibiting selfish behavior?  I work as a nurse in Ohio.  On my way to work on Thursday at 7AM, there seemed to be as many cars on the road as ever.  I mentioned it to my coworkers who all agreed.  I wondered where these people were going.  Later in the day one coworker mentioned about going to Lowes.  When I said, is Lowes is an essential business?  She said, yes of course it is- in case someone's water heater goes out.  I don't think she was buying a water heater.  She didn't mention it going out.  I do know that they are remodeling their house.  Another person was surfing the net for  VRBO rentals for her  daughter who was missing prom.  She thought that she had a few of her friends could go for a few days and bond to make up for their ruined senior year.  At the park, I see more people out and about, although recently I've noticed people being better about social distancing. 
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on March 28, 2020, 11:10:38 AM
DeWine and Dr. Acton are using models that show that Ohio's surge won't come until mid-May, while this shows our surge in a couple weeks.

I live in Ohio.  Anecdotal evidence yes, but, I think people just like to think they are doing what they are suppose to be doing.  Who wants to admit they are exhibiting selfish behavior?  I work as a nurse in Ohio.  On my way to work on Thursday at 7AM, there seemed to be as many cars on the road as ever.  I mentioned it to my coworkers who all agreed.  I wondered where these people were going.  Later in the day one coworker mentioned about going to Lowes.  When I said, is Lowes is an essential business?  She said, yes of course it is- in case someone's water heater goes out.  I don't think she was buying a water heater.  She didn't mention it going out.  I do know that they are remodeling their house.  Another person was surfing the net for  VRBO rentals for her  daughter who was missing prom.  She thought that she had a few of her friends could go for a few days and bond to make up for their ruined senior year.  At the park, I see more people out and about, although recently I've noticed people being better about social distancing.
[/quote]

Perhaps Gov Dewine's projections assume 50-75% success at social distancing, which would delay peak till early May? Seems more realistic to me.
Title: Re: How long can we wait while flattening the curve?
Post by: Luz on March 28, 2020, 01:32:13 PM
Interesting bit on NPR about the effects of quarantined during the 1918 pandemic. As expected cities which took more comprehensive measures had far fewer deaths, but what was surprising was that these same cities did better economically over the following year.

Do you have a link?  Did they have any ideas as to why?
Title: Re: How long can we wait while flattening the curve?
Post by: BostonBrit on March 28, 2020, 01:42:45 PM
Everyone wil have their own tilt and lens to look at this through but here's the latest primary research from Imperial:

https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-Global-Impact-26-03-2020.pdf

The key quote is:

We do not consider the wider social and economic costs of suppression, which will be high and may be disproportionately so in lower income settings. Moreover,suppression strategies will  need  to  be maintained in  some  manner until  vaccines or  effective treatments become available to avoid the risk of later epidemics.

In the table example at the back (page 11) they give the impact if lockdowns are maintained for 250 days. So I suppose that is an indication of how long you're talking which I believe was the OPs question.
Title: How long can we wait while flattening the curve?
Post by: the_fixer on March 28, 2020, 01:43:19 PM
Interesting bit on NPR about the effects of quarantined during the 1918 pandemic. As expected cities which took more comprehensive measures had far fewer deaths, but what was surprising was that these same cities did better economically over the following year.

Do you have a link?  Did they have any ideas as to why?
Not sure why that would be surprising if the residents come out of it healthier than other city’s and had less financial impact to the individuals they can get back to work making stuff and spending sooner.

This will also be true for countries the faster they get out from under the virus and with the healthiest possible workforce the sooner they will be able to take the lead in jump starting their economy.

China will be back humming along Italy will really struggle and the US who know at this point.


Sent from my iPhone using Tapatalk
Title: Re: How long can we wait while flattening the curve?
Post by: renata ricotta on March 28, 2020, 01:44:38 PM
Interesting bit on NPR about the effects of quarantined during the 1918 pandemic. As expected cities which took more comprehensive measures had far fewer deaths, but what was surprising was that these same cities did better economically over the following year.

Do you have a link?  Did they have any ideas as to why?

You can do your own research to find the summarized MIT study, but I heard it on NPR this morning. https://www.npr.org/2020/03/28/823071188/what-is-the-economic-cost-of-social-distancing:

HORSLEY: Back then, they were shuttering schools and theaters. They outlawed public gatherings. Verner says some cities, like Omaha and Spokane, were more aggressive than others, like Boston and Pittsburgh, so it gives us kind of a natural experiment to see how that played out.

VERNER: And what did they find?

HORSLEY: Not surprisingly, the cities that acted quickly and forcefully to enforce what we would now call social distancing measures had fewer deaths from the flu. What's striking, though, Verner says is they also perform better economically. And that's because the pandemic itself takes a toll on the economy. People don't shop and spend the way they would otherwise in a raging pandemic and a serious outbreak like what we saw in 1918 leaves long-lasting economic scars.

VERNER: There doesn't appear to be a tradeoff between saving lives and supporting the economy. If anything, the data suggests that these cities that intervene more aggressively actually did better in terms of their economy in the year after the pandemics.

HORSLEY: Now Verner says the most aggressive cities left their social distancing policies in place for 100 days or more.

Title: Re: How long can we wait while flattening the curve?
Post by: Luz on March 28, 2020, 02:03:53 PM
Interesting bit on NPR about the effects of quarantined during the 1918 pandemic. As expected cities which took more comprehensive measures had far fewer deaths, but what was surprising was that these same cities did better economically over the following year.

Do you have a link?  Did they have any ideas as to why?
Not sure why that would be surprising if the residents come out of it healthier than other city’s and had less financial impact to the individuals they can get back to work making stuff and spending sooner.

This will also be true for countries the faster they get out from under the virus and with the healthiest possible workforce the sooner they will be able to take the lead in jump starting their economy.

China will be back humming along Italy will really struggle and the US who know at this point.


Sent from my iPhone using Tapatalk

But in the case of the Coronavirus, it would seem that the majority of working-age adults would be out of work for a few weeks if ill. Rather than months on end with lockdowns. And most (though not all) in this age group can expect to avoid serious illness, especially if they don't have underlying medical issues.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on March 28, 2020, 02:15:33 PM
https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3561560

MIT Paper, not peer reviewed yet.

I'd say looking at Figure 6 that there is a weak association between social distancing, etc and subsequent economic growth. A more conservative way to interpret the data is that lockdowns do not appear to have long-term sequelae for high-mortality influenza epidemics.

Applicability to today's economy is unclear. On one hand, more jobs can be done remotely and our social safety net is better than it was in 1918. On the other hand, companies tend to have lower reserves (look up zombie companies) and are not as resilient as big manufacturers were. We also are a lot more economically dependent on luxury services (i.e. jacuzzi manufacturing, nail salons, gym classes) than we were in 1918.
Title: Re: How long can we wait while flattening the curve?
Post by: Luz on March 28, 2020, 02:22:06 PM
Interesting bit on NPR about the effects of quarantined during the 1918 pandemic. As expected cities which took more comprehensive measures had far fewer deaths, but what was surprising was that these same cities did better economically over the following year.

Do you have a link?  Did they have any ideas as to why?

You can do your own research to find the summarized MIT study, but I heard it on NPR this morning. https://www.npr.org/2020/03/28/823071188/what-is-the-economic-cost-of-social-distancing:

HORSLEY: Back then, they were shuttering schools and theaters. They outlawed public gatherings. Verner says some cities, like Omaha and Spokane, were more aggressive than others, like Boston and Pittsburgh, so it gives us kind of a natural experiment to see how that played out.

VERNER: And what did they find?

HORSLEY: Not surprisingly, the cities that acted quickly and forcefully to enforce what we would now call social distancing measures had fewer deaths from the flu. What's striking, though, Verner says is they also perform better economically. And that's because the pandemic itself takes a toll on the economy. People don't shop and spend the way they would otherwise in a raging pandemic and a serious outbreak like what we saw in 1918 leaves long-lasting economic scars.

VERNER: There doesn't appear to be a tradeoff between saving lives and supporting the economy. If anything, the data suggests that these cities that intervene more aggressively actually did better in terms of their economy in the year after the pandemics.

HORSLEY: Now Verner says the most aggressive cities left their social distancing policies in place for 100 days or more.

Thanks! Does the rate of deaths per age matter in this analysis? From my limited understanding, the distribution of death in both the Coronavirus and the 1918 flu are/were uncommon. Death by diseases of this sort are usually better distributed among the very old, very young, pregnant women, and those with underlying medical conditions. In the 1918 flu, it was young adults who were hit hard. In the Coronavirus, kids age 0-5 and pregnant women seem to fare the same as those in young and middle adulthood.
It makes me wonder how impact to the economy compares (especially in terms of anxiety) if those who are healthy and in their working years can reasonably expect to avoid severe illness, despite Corona being quite contagious.
Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on March 28, 2020, 02:29:12 PM
Interesting bit on NPR about the effects of quarantined during the 1918 pandemic. As expected cities which took more comprehensive measures had far fewer deaths, but what was surprising was that these same cities did better economically over the following year.

Do you have a link?  Did they have any ideas as to why?
Not sure why that would be surprising if the residents come out of it healthier than other city’s and had less financial impact to the individuals they can get back to work making stuff and spending sooner.

This will also be true for countries the faster they get out from under the virus and with the healthiest possible workforce the sooner they will be able to take the lead in jump starting their economy.

China will be back humming along Italy will really struggle and the US who know at this point.


Sent from my iPhone using Tapatalk

But in the case of the Coronavirus, it would seem that the majority of workers (those age 18-65) would be out of work for a few weeks if ill. Rather than months on end with lockdowns.
And if you let it fester how many people, tourists and ETC are going to want to go out and eat, spend, buy?

How many people are going to be in survival mode and afraid to spend money?


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Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 28, 2020, 02:59:46 PM
In what alternate universe are people living in where they think if there were not a stay at home order no one would lose their jobs and life would return to normal next week? The number of cases would be rising faster, more people would be dying, people would not be rushing out to bars and restaurants, people would not be packing into airplanes, the stories about triaging at hospitals would be worse, etc, etc.

The virus is the problem, not the stay at home orders.

Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 28, 2020, 03:59:14 PM
(https://i.imgflip.com/3ugeho.jpg)
Title: Re: How long can we wait while flattening the curve?
Post by: secondcor521 on March 28, 2020, 06:47:05 PM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

I appreciate their effort.  I can say two things about the site:

1.  For my state (Idaho), they show that we have not implemented the first three items at the top, when in fact we have.  Perhaps their information is out of date.

2.  If ventilators = invasive ventilators, then the number of ventilators predicted to be needed does not square with Governor Cuomo's estimates.  The site says NY will need 4,141 ventilators.  Governor Cuomo stated he needed a minimum of 30,000 additional ventilators on 3/24 per https://www.worldometers.info/coronavirus/country/us.
Title: Re: How long can we wait while flattening the curve?
Post by: aspiringnomad on March 28, 2020, 08:25:07 PM
If you need a laugh right now, watch this.

https://twitter.com/kenolin1/status/1242852430582341639?s=20

Haha, holy shit this is the best impression I've seen so far. In terms of the monologue, I'd guess it's about 95% potential reality and just 5% complete parody.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on March 28, 2020, 10:25:34 PM
Currently there’s about 1200 on ventilators in NYC, and the outbreak’s sequelae are really only just beginning by most estimates. Most hospitals are near capacity regardless. I think the 4900 estimate is too low based on the current situation.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on March 29, 2020, 05:12:32 AM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

I appreciate their effort.  I can say two things about the site:

1.  For my state (Idaho), they show that we have not implemented the first three items at the top, when in fact we have.  Perhaps their information is out of date.

2.  If ventilators = invasive ventilators, then the number of ventilators predicted to be needed does not square with Governor Cuomo's estimates.  The site says NY will need 4,141 ventilators.  Governor Cuomo stated he needed a minimum of 30,000 additional ventilators on 3/24 per https://www.worldometers.info/coronavirus/country/us.

Ffs. Does it matter if you over supply in the current climate? Nope. Does it matter if you undersupply? YEP.
Title: Re: How long can we wait while flattening the curve?
Post by: Jon Bon on March 29, 2020, 05:48:43 AM
State leaders are not immune to hoarding medical supplies either.

Maybe I am choosing to give the study more weight just because I am an optimist, maybe that is foolish, but it helps me get through the day.

First time I have seen actual data on the spread and growth, other then just wild speculation thrown around. That is really all I was trying to point out to the thread. As this goes on our data will get better, therefore so will our predictions about how severe this can get.

Title: Re: How long can we wait while flattening the curve?
Post by: Kyle Schuant on March 29, 2020, 06:16:58 AM

And while everyone here in Australia is unemployed, anxious and fearful, and domestic violence is increasing... we are going to close playgrounds, but... keep bottle shops open.

Really?

'Straya! Trying to be as dumb as America since 1962.

Title: Re: How long can we wait while flattening the curve?
Post by: BostonBrit on March 29, 2020, 06:20:46 AM
2 issues that need to be understood.

1) World ex-China is not looking to eradicate this (genie is out the bottle) and are instead trying to slow spread to match constraining factor which equals, ventilators, ICU beds and healthcare workers.

Do some simple maths - which is all open to debate.

US population = 320m
Target exposure = 60%
Target people = 190m
Need ICU = 2.5% = 4.75m people
Need ventilator = 50% of above = 2.4m people
Average time on ventilator = 10 days - 24m ventilator days.
Number of ventilators in US = 175,000
Time to rotate through ventilators = 136 days = 4.5 months.

Loads of assumptions in the above that are a) open to debate and b) we are getting new information on daily and so will change. The big unknown, and why testing both pre and post, is understanding what the actual denominator is to understand if that ICU number is 2.5% or 15% as the Italian data would optically suggest (which implies cases is actually far higher IMO).

2) The problem is that those flatten the curve charts are directionally right. But the issue that's not been conveyed to the general public is that the two axis are logarithmic in nature.

So simplistically, and to answer the thread opening question, you're looking at an absolute minimum of 3 months but up to 9 months. All of this is based on data which can be impacted by medical developments, but these are at least 3 months off at this point.



Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on March 29, 2020, 07:34:59 AM

And while everyone here in Australia is unemployed, anxious and fearful, and domestic violence is increasing... we are going to close playgrounds, but... keep bottle shops open.

Really?

'Straya! Trying to be as dumb as America since 1962.

If "bottle shop" is a place to buy alcohol (what we would call a liquor store), I also thought it was ridiculous to keep those stores open until someone pointed out to me that the last thing emergency rooms need is an influx of alcoholics going through withdrawal right now. I don't know if that was the rationale used by governments to keep them open.
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on March 29, 2020, 07:39:40 AM
Meh.  You can make hand sanitizer with vodka.


Which finally creates a use for the stuff.  :P
Title: Re: How long can we wait while flattening the curve?
Post by: Laserjet3051 on March 29, 2020, 07:49:54 AM

And while everyone here in Australia is unemployed, anxious and fearful, and domestic violence is increasing... we are going to close playgrounds, but... keep bottle shops open.

Really?

'Straya! Trying to be as dumb as America since 1962.

If "bottle shop" is a place to buy alcohol (what we would call a liquor store), I also thought it was ridiculous to keep those stores open until someone pointed out to me that the last thing emergency rooms need is an influx of alcoholics going through withdrawal right now. I don't know if that was the rationale used by governments to keep them open.

The rationale underlying keeping "bottle shops" as well as rec. MJ dispensaries open is incredibly clear. In order for governments to keep  billions of people fully placated while forcing them into lockdown, the populous must be kept drunk, stoned, and drugged. Very effective strateggy for quelling the inevitable uprisings after prolonged quarantine.
Title: Re: How long can we wait while flattening the curve?
Post by: KBecks on March 29, 2020, 08:25:56 AM
Abbott has made a 5-minute testing device:
https://www.bloomberg.com/news/articles/2020-03-27/abbott-launches-5-minute-covid-19-test-for-use-almost-anywhere

Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on March 29, 2020, 08:38:04 AM

And while everyone here in Australia is unemployed, anxious and fearful, and domestic violence is increasing... we are going to close playgrounds, but... keep bottle shops open.

Really?

'Straya! Trying to be as dumb as America since 1962.

This is not a dumb move. We see this with hurricanes*. Alcohol is a vital supply used to keep (most) people calm. Same thing with pot stores where that's now legal. 

State liquor stores are open here with breweries and distilleries now allowed to offer home delivery! And I for one am glad that this public service will continue.

*(for the hurricane challenged, imagine winds howling for 12 hours or more. It's like listening to a freight train for hours. You're holed up, the electricity is usually out, you can't sleep, and are hoping that a tree doesn't fall on you. It sucks.) 
Title: Re: How long can we wait while flattening the curve?
Post by: secondcor521 on March 29, 2020, 08:38:29 AM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

I appreciate their effort.  I can say two things about the site:

1.  For my state (Idaho), they show that we have not implemented the first three items at the top, when in fact we have.  Perhaps their information is out of date.

2.  If ventilators = invasive ventilators, then the number of ventilators predicted to be needed does not square with Governor Cuomo's estimates.  The site says NY will need 4,141 ventilators.  Governor Cuomo stated he needed a minimum of 30,000 additional ventilators on 3/24 per https://www.worldometers.info/coronavirus/country/us.

Ffs. Does it matter if you over supply in the current climate? Nope. Does it matter if you undersupply? YEP.

Of course, and I agree with your point completely.

My point, which you may have missed or ignored, is that the data at the site is not one I would rely on because it appears to me to be inaccurate in major ways based on personal experience which is readily fact-checkable (point 1) and on recent published statements by an elected governor based on health experts which are also readily fact-checkable (point 2).
Title: Re: How long can we wait while flattening the curve?
Post by: KBecks on March 29, 2020, 08:48:56 AM
Here is a study on using a combination of two drugs to combat COVID-19.  I am not accustomed to reading research papers but those of you who are may be interested.

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

It seems that this drug combination may help reduce the impacts of the virus.  It also sounds like New York started its own use/trials of this combination on Tuesday.
Title: Re: How long can we wait while flattening the curve?
Post by: bmjohnson35 on March 29, 2020, 08:56:27 AM

Another interesting article..........it's a long read and more of an opinion and speculation article, but it raises a lot to think about as we live through this thing and try to forecast our future.

https://www.theatlantic.com/health/archive/2020/03/how-will-coronavirus-end/608719/

BJ
Title: Re: How long can we wait while flattening the curve?
Post by: Laserjet3051 on March 29, 2020, 09:19:43 AM
Here is a study on using a combination of two drugs to combat COVID-19.  I am not accustomed to reading research papers but those of you who are may be interested.

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

It seems that this drug combination may help reduce the impacts of the virus.  It also sounds like New York started its own use/trials of this combination on Tuesday.

This report doesnt seem to have included a control group, which is essential in determining treatment efficacy. The purported efficacy in treatment resulted in a decrease in both viral load and time to hospital discharge. One wonders if a placebo control group would have exhibited identical outcomes. The authors do compare their findings to (recent) historical viral loads and discharge rates and make the claim that the treatment was effective. The conclusion hinges on this comparison, which is to be honest, weak, BUT encouraging as the (historic) control group data from other countries, patient demographics, etc.  may not necessarily be reflective of the control data that should have been obtained empirically in this study. I get it, one cant always generate such data internally, but without that comparison, claims of efficacy are limited in confidence. What we need, and are currently conducting, are fully controlled preclinical and clinical studies. We will know soon.
Title: Re: How long can we wait while flattening the curve?
Post by: Hirondelle on March 29, 2020, 09:54:14 AM

Due to the lack of testing, we are flying blind with this outbreak. More Tests Equal More Confirmed Cases. Less confirmed cases does not mean less cases!
Deaths are deaths, though, they're a bit harder to hide: https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html (https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html)

yeah but to be useful number of deaths reallly needs to be normalized. its not useful to compare number of deaths in us (350m people) to italy (60m people).

also, are we really testing everyone that dies with covid symptoms? without a test, cause of death could be pneumonia, heart failure or something else. when tests are so limited why waste a test on someone that is dead or going to die anyway? especially when that test could be used to test a health care worker or someone who lived in a group setting, potentially infecting many others.

Are all corpses tested for coronavirus?  If they're not, you might not know the real numbers.

In my country corpses are not tested. Can't speak for other places.

It does look like there's an underreporting of COVID-related deaths though. Look at this (https://www.corriere.it/politica/20_marzo_26/the-real-death-toll-for-covid-19-is-at-least-4-times-the-official-numbers-b5af0edc-6eeb-11ea-925b-a0c3cdbe1130.shtml) and  this  (https://elpais.com/sociedad/2020-03-27/el-coronavirus-causa-mas-muertes-de-las-detectadas.html) link where they compare the number of 'expected' deaths to the number of actual deaths and the number of deaths attributed to COVID in some areas in Italy and Spain. There's a huge gap of unexplained deaths.

This is probably a combination of non-diagnosed COVID deaths and collateral damage as ERs report to see few people with heart issues, appendix issues, liver failure etc (like, ER visits that you don't expect to plummet overnight) as people don't dare to go to the ER, either due to fear of catching COVID or because they think they're too busy there. So the damage of the lack of testing, the overrun medical systems and the folks that are too scared to go to ER even if they have severe complaints is probably much, much worse than the actual deaths reported. 
Title: Re: How long can we wait while flattening the curve?
Post by: wenchsenior on March 29, 2020, 10:05:13 AM

And while everyone here in Australia is unemployed, anxious and fearful, and domestic violence is increasing... we are going to close playgrounds, but... keep bottle shops open.

Really?

'Straya! Trying to be as dumb as America since 1962.

This is not a dumb move. We see this with hurricanes*. Alcohol is a vital supply used to keep (most) people calm. Same thing with pot stores where that's now legal. 

State liquor stores are open here with breweries and distilleries now allowed to offer home delivery! And I for one am glad that this public service will continue.

*(for the hurricane challenged, imagine winds howling for 12 hours or more. It's like listening to a freight train for hours. You're holed up, the electricity is usually out, you can't sleep, and are hoping that a tree doesn't fall on you. It sucks.)

I think it's mostly psychological...one certainly doesn't need booze to get through hurricanes (speaking from experience riding out 2 category 3s). And I certainly wouldn't want to face the next day hungover. Jesus, what a nightmare that would be.

However, for the many MANY members of the population who are physically addicted to alcohol, sudden withdrawal can certainly kill you, so I suspect part of the reason for keeping liquor stores open is to reduce both fatalities and also the addicts roaming around outside either drunk or withdrawing, panicking from lack of access.
Title: Re: How long can we wait while flattening the curve?
Post by: former player on March 29, 2020, 12:20:32 PM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

I appreciate their effort.  I can say two things about the site:

1.  For my state (Idaho), they show that we have not implemented the first three items at the top, when in fact we have.  Perhaps their information is out of date.

2.  If ventilators = invasive ventilators, then the number of ventilators predicted to be needed does not square with Governor Cuomo's estimates.  The site says NY will need 4,141 ventilators.  Governor Cuomo stated he needed a minimum of 30,000 additional ventilators on 3/24 per https://www.worldometers.info/coronavirus/country/us.

Ffs. Does it matter if you over supply in the current climate? Nope. Does it matter if you undersupply? YEP.

Of course, and I agree with your point completely.

My point, which you may have missed or ignored, is that the data at the site is not one I would rely on because it appears to me to be inaccurate in major ways based on personal experience which is readily fact-checkable (point 1) and on recent published statements by an elected governor based on health experts which are also readily fact-checkable (point 2).
Just in case anyone thinks that having an adequate supply of ventilators solves the problems, current UK information is that 50% of covid-19 sufferers who need ventilation die in any case (and forum member and doctor Abe posted figures of 60%+ out of NY).
Title: Re: How long can we wait while flattening the curve?
Post by: KBecks on March 29, 2020, 12:22:21 PM
And in the UK, Dyson designed and is producing 15,000 new ventilators.
Might not solve everything, but I am sure it will help.

https://cbs58.com/news/dyson-designed-a-new-ventilator-in-10-days-now-the-company-is-making-15-000-for-the-pandemic-fight?fbclid=IwAR2BnXyvnOqLYwnGJcJVn6P2QXGH9w4DWC0BaVki_ZcFEONqf20fRfrMc1s
Title: Re: How long can we wait while flattening the curve?
Post by: BostonBrit on March 29, 2020, 12:44:41 PM
Well me might have an actual answer now that we have some data. I much prefer math over stories just trying to get clicks.

https://covid19.healthdata.org/projections

Very interesting to see the how some states are much further along than others, and how some states have accomplished a flattening of the curve.

I cannot speak to their methods, data, or assumptions. But its a start.

I appreciate their effort.  I can say two things about the site:

1.  For my state (Idaho), they show that we have not implemented the first three items at the top, when in fact we have.  Perhaps their information is out of date.

2.  If ventilators = invasive ventilators, then the number of ventilators predicted to be needed does not square with Governor Cuomo's estimates.  The site says NY will need 4,141 ventilators.  Governor Cuomo stated he needed a minimum of 30,000 additional ventilators on 3/24 per https://www.worldometers.info/coronavirus/country/us.

Ffs. Does it matter if you over supply in the current climate? Nope. Does it matter if you undersupply? YEP.

Of course, and I agree with your point completely.

My point, which you may have missed or ignored, is that the data at the site is not one I would rely on because it appears to me to be inaccurate in major ways based on personal experience which is readily fact-checkable (point 1) and on recent published statements by an elected governor based on health experts which are also readily fact-checkable (point 2).
Just in case anyone thinks that having an adequate supply of ventilators solves the problems, current UK information is that 50% of covid-19 sufferers who need ventilation die in any case (and forum member and doctor Abe posted figures of 60%+ out of NY).

Very true...   BUT 100% of ventilators that need ventilation who don't get a ventilation die.

On the original trajectory of the virus (pre- flattening), the numbers needing ventilators was 8x the number of ventilators.

So continuing your point, 8.5/9 so 94% who need ventilators would die vs 50%.. and there is a hope that as medical knowledge improves that 50% rate decreases as does the % needing ventilation.

Either way - grim
Title: Re: How long can we wait while flattening the curve?
Post by: ice_beard on March 29, 2020, 02:13:20 PM
Everyone keeps talking about ventilators as some sort of cure all.  I have news for you all...it takes a TEAM of medical professionals to take care of ventilated patients.  Respiratory therapists, nurses, nursing assistants and MDs to oversee the care of these ventilated patients.  The typical ratio for ventilated patients to nurses is 2:1.  Given these are atypical times, 3:1 and possibly even higher ratios could be a possibility I don't doubt.  So if you need 20,000 ventilators, they'd better come with 10,000 trained nurses who know how to care for vented patients. 
Source: ICU RN
Title: Re: How long can we wait while flattening the curve?
Post by: wanderlustNW on March 29, 2020, 02:29:23 PM
Everyone keeps talking about ventilators as some sort of cure all.  I have news for you all...it takes a TEAM of medical professionals to take care of ventilated patients.  Respiratory therapists, nurses, nursing assistants and MDs to oversee the care of these ventilated patients.  The typical ratio for ventilated patients to nurses is 2:1.  Given these are atypical times, 3:1 and possibly even higher ratios could be a possibility I don't doubt.  So if you need 20,000 ventilators, they'd better come with 10,000 trained nurses who know how to care for vented patients. 
Source: ICU RN

Thank you! I'm a radiation therapist and was trying to explain this to friends. They thought you just hook people up to these and any ol' person can just run it. It takes specialized people who know what they are doing to take care of these patients. The patients also need to be under anesthesia.

They thought I could also explain to someone in a matter of a few weeks how to do my job. Uh....if you wanna irradiate the wrong part of the body go for it.
Title: Re: How long can we wait while flattening the curve?
Post by: BostonBrit on March 29, 2020, 05:37:51 PM
Everyone keeps talking about ventilators as some sort of cure all.  I have news for you all...it takes a TEAM of medical professionals to take care of ventilated patients.  Respiratory therapists, nurses, nursing assistants and MDs to oversee the care of these ventilated patients.  The typical ratio for ventilated patients to nurses is 2:1.  Given these are atypical times, 3:1 and possibly even higher ratios could be a possibility I don't doubt.  So if you need 20,000 ventilators, they'd better come with 10,000 trained nurses who know how to care for vented patients. 
Source: ICU RN

Couldn't agree more
Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on March 30, 2020, 07:39:21 AM
Everyone keeps talking about ventilators as some sort of cure all.  I have news for you all...it takes a TEAM of medical professionals to take care of ventilated patients.  Respiratory therapists, nurses, nursing assistants and MDs to oversee the care of these ventilated patients.  The typical ratio for ventilated patients to nurses is 2:1.  Given these are atypical times, 3:1 and possibly even higher ratios could be a possibility I don't doubt.  So if you need 20,000 ventilators, they'd better come with 10,000 trained nurses who know how to care for vented patients. 
Source: ICU RN

Couldn't agree more
Yes this. And also another factor as to why we normal folks need to do everything we can to slow this thing down.
Title: Re: How long can we wait while flattening the curve?
Post by: GettingClose on March 30, 2020, 03:10:38 PM
Quote
So if you need 20,000 ventilators, they'd better come with 10,000 trained nurses

Really more like 30,000 trained nurses, since you need a nurse for each 12-hour shift each day, and most nurses work 3 shifts a week.

My sister is a certified nurse midwife, working in a New England hospital, and she just worked 84 hours in 9 days (many labor and delivery nurses and midwives out with COVID-19 or conditions like pregnancy, cancer treatment, etc. that make it unwise to come in).  It's impossible to keep that up for more a couple of weeks.
Title: Re: How long can we wait while flattening the curve?
Post by: Sibley on March 30, 2020, 04:57:51 PM
Here is a study on using a combination of two drugs to combat COVID-19.  I am not accustomed to reading research papers but those of you who are may be interested.

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

It seems that this drug combination may help reduce the impacts of the virus.  It also sounds like New York started its own use/trials of this combination on Tuesday.

This report doesnt seem to have included a control group, which is essential in determining treatment efficacy. The purported efficacy in treatment resulted in a decrease in both viral load and time to hospital discharge. One wonders if a placebo control group would have exhibited identical outcomes. The authors do compare their findings to (recent) historical viral loads and discharge rates and make the claim that the treatment was effective. The conclusion hinges on this comparison, which is to be honest, weak, BUT encouraging as the (historic) control group data from other countries, patient demographics, etc.  may not necessarily be reflective of the control data that should have been obtained empirically in this study. I get it, one cant always generate such data internally, but without that comparison, claims of efficacy are limited in confidence. What we need, and are currently conducting, are fully controlled preclinical and clinical studies. We will know soon.

The other piece of that puzzle is supply. If the medications appear to be effective, every hospital across the world is going to be trying to get ahold of those drugs. And it doesn't matter how common they are, the supply is finite. Sure, manufacturers could try to increase production, but I'm guessing that it's actually that easy - shifting whatever is needed physically in the factory, getting raw ingredients, etc is going to take time. There's also a finite supply of the raw ingredients.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on March 30, 2020, 05:22:40 PM
Everyone keeps talking about ventilators as some sort of cure all.  I have news for you all...it takes a TEAM of medical professionals to take care of ventilated patients.  Respiratory therapists, nurses, nursing assistants and MDs to oversee the care of these ventilated patients.  The typical ratio for ventilated patients to nurses is 2:1.  Given these are atypical times, 3:1 and possibly even higher ratios could be a possibility I don't doubt.  So if you need 20,000 ventilators, they'd better come with 10,000 trained nurses who know how to care for vented patients. 
Source: ICU RN
Bingo. The problem isn’t just the ventilators.  It’s the doctors and nurses and other health professionals. How many weeks of sheer hell do we expect them to be able endure?
Title: Re: How long can we wait while flattening the curve?
Post by: bacchi on March 30, 2020, 05:33:47 PM
Everyone keeps talking about ventilators as some sort of cure all.  I have news for you all...it takes a TEAM of medical professionals to take care of ventilated patients.  Respiratory therapists, nurses, nursing assistants and MDs to oversee the care of these ventilated patients.  The typical ratio for ventilated patients to nurses is 2:1.  Given these are atypical times, 3:1 and possibly even higher ratios could be a possibility I don't doubt.  So if you need 20,000 ventilators, they'd better come with 10,000 trained nurses who know how to care for vented patients. 
Source: ICU RN
Bingo. The problem isn’t just the ventilators.  It’s the doctors and nurses and other health professionals. How many weeks of sheer hell do we expect them to be able endure?

How would removing social distancing guidelines fix this? Wouldn't that mean overwhelmed hospitals? Is it the idea that it's more pain over a shorter time vs spreading out the pain over a longer time?
Title: Re: How long can we wait while flattening the curve?
Post by: Kyle Schuant on March 30, 2020, 06:29:53 PM

This is not a dumb move. We see this with hurricanes*. Alcohol is a vital supply used to keep (most) people calm. Same thing with pot stores where that's now legal. 

Increasing accessibility of alcohol increases violence and suicide. Reducing it reduces those.

Keeping people calm? Well...


"Alcohol abuse is a means of easing one’s psychological stress but, at the same time, impacts on all other factors, rendering suicide more likely."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872355

"the repeal of Sunday alcohol-sales restrictions may increase crime in poor urban areas."
https://www.sciencedaily.com/releases/2016/04/160425100417.htm (https://www.sciencedaily.com/releases/2016/04/160425100417.htm)

"Harmful use of alcohol is a major contributor to violence. Studies have shown that
violence can be cut by reducing the availability of alcohol through regulating sales outlets
and hours and prices; by providing brief interventions and longer-term treatment for
problem drinkers; and by improving the management of environments in which alcohol is
served."
https://www.who.int/violence_injury_prevention/violence/alcohol.pdf (https://www.who.int/violence_injury_prevention/violence/alcohol.pdf)



Title: Re: How long can we wait while flattening the curve?
Post by: WaterproofBanjo on March 30, 2020, 06:54:18 PM
Realizing that the original post was on March 17... a lot has happened since then. 

As painful as it is to shut everything down, I'm not really seeing the alternative.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 30, 2020, 07:45:12 PM
How many weeks of sheer hell do we expect them to be able endure?

I would like to flatten the curve and save lives, and hopefully avoid too many medical professionals with PTSD. With that said, every nurse and doctor in the country knew when they signed up that they might get to see a war or epidemic or otherwise witness years of pure hell. That's part of the job.
Title: Re: How long can we wait while flattening the curve?
Post by: MoseyingAlong on March 30, 2020, 08:12:01 PM
How many weeks of sheer hell do we expect them to be able endure?

I would like to flatten the curve and save lives, and hopefully avoid too many medical professionals with PTSD. With that said, every nurse and doctor in the country knew when they signed up that they might get to see a war or epidemic or otherwise witness years of pure hell. That's part of the job.

Yeah....no.
I, and I'd guess all my nursing school classmates, anticipated rough shifts and busy months but "years of pure hell"...no.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on March 30, 2020, 08:29:51 PM
 Yeah there's nothing in any civilian healthcare workforce contract expecting to be drafted into a war or years of pure hell anymore than anyone else. Epidemic, maybe. I've seen more death than pretty much anyone on this forum other than active duty military, veterans or ICU workers. Let's just say I wouldn't be so flippant about its effects.
Title: Re: How long can we wait while flattening the curve?
Post by: Sailor Sam on March 30, 2020, 08:40:59 PM
How many weeks of sheer hell do we expect them to be able endure?

I would like to flatten the curve and save lives, and hopefully avoid too many medical professionals with PTSD. With that said, every nurse and doctor in the country knew when they signed up that they might get to see a war or epidemic or otherwise witness years of pure hell. That's part of the job.

I went to Haiti after the earthquake.

I remember that some neighbourhoods protested the slowness of Hatian emergency response by piling their beloved dead like cordons. I remember a man tossing dead children, cartwheeling them through the air, out of a school gymnasium. He was certainly a standard human being, who cared the standard human amount about his fellow man, and he'd reached a capacity where he was tossing broken, crushed, dead children like sacks of grain. One of the kids has his brains spilling out the side of his head. He looked so odd - a little black kid so covered in dust he was tan, with a grey jelly leaking down his face.

I think about that man a fair amount. Is that just part of my job?
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on March 30, 2020, 10:20:53 PM
Realizing that the original post was on March 17... a lot has happened since then. 
  • There's currently 45 refrigerated trailers parked in NYC for dealing with COVID-19 deaths.
  • I work in the medical-industrial complex, and my industry is scrambling to figure out how to supply hundreds of thousands of ventilators to keep people alive.
  • Medical professionals are scared, overwhelmed, but still showing up (thank you).
  • In general, you're better off the younger you are, but there's also plenty of counter-examples who that hasn't worked out for.

As painful as it is to shut everything down, I'm not really seeing the alternative.

Yes. And:

https://www.nytimes.com/2020/03/30/us/coronavirus-funeral-albany-georgia.html?action=click&module=Spotlight&pgtype=Homepage (https://www.nytimes.com/2020/03/30/us/coronavirus-funeral-albany-georgia.html?action=click&module=Spotlight&pgtype=Homepage)
and
https://www.google.com/amp/s/www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak%3f_amp=true (https://www.google.com/amp/s/www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak%3f_amp=true)

Too often, we don't know that someone in the room is infected until it's too late. Stay the fuck home.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 30, 2020, 10:34:10 PM
Yeah....no.
I, and I'd guess all my nursing school classmates, anticipated rough shifts and busy months but "years of pure hell"...no.

Did they miss the last 300 years of history in high-school and college? Because I had to take a full year of history for my BS.*

My family lost people in the 1918 pandemic. Other parts of my family lived through the western front of WWII and the Chinese civil war. I reject the premise that today's generations could have reasonably expected to not have to live through any similar events.

EDITed to add: * - that might not be fair. I think that technically I could have taken a different social science and I chose to take history, including a graduate level course on the French Revolution. Shit can get real bad real fast, and I promise you that we are not immune. 
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 30, 2020, 10:38:18 PM
I think about that man a fair amount. Is that just part of my job?

I grew up with stories of the bodies stacked up in North Dakota in 1918 because the ground was still frozen, and this was before anyone had heavy equipment to dig graves. I think that Americans are good at forgetting history, but one of those bodies was my great grandfather and my grandfather made sure that I knew it.

Maybe I should put it another way: no cop deserves to have to shoot someone, but they all know that they might have to. They made that choice when they took the job, which is a hell of a lot better than being a conscript during WWI.
Title: Re: How long can we wait while flattening the curve?
Post by: MoseyingAlong on March 30, 2020, 11:10:33 PM
Yeah....no.
I, and I'd guess all my nursing school classmates, anticipated rough shifts and busy months but "years of pure hell"...no.

Did they miss the last 300 years of history in high-school and college? Because I had to take a full year of history for my BS.*

My family lost people in the 1918 pandemic. Other parts of my family lived through the western front of WWII and the Chinese civil war. I reject the premise that today's generations could have reasonably expected to not have to live through any similar events.


When we were in the military, sure, bring it on.
Civilian healthcare, not government, yeah...no.

There's a difference between a society going thru something and expecting individuals to go thru a specific type of hell. 
Title: Re: How long can we wait while flattening the curve?
Post by: Sailor Sam on March 30, 2020, 11:15:25 PM
Of course people know bad things are coming.

Over the course of a 15 year career, I’ve responded to six hurricanes, and one earthquake. Haiti, Katrina, Maria, Michael, Florence, Dorian. Each response left me with something that will never leave my brain. Haiti above all. The saving grace is that I’ve been able to spread those moments out across 15 years, with gaps in between.

You’re asking medical workers to live disaster response day, after day, after day, for an untold amount of time. To use your analogy: it’s asking a LEO to shoot someone in the line of duty every day, and telling them it’s just part of their job. It’s an astonishing lack of compassion.

@Abe has “First Do No Harm.” @MoseyingAlong has a vocation that stretches back as far as humans. I have “Honor, Respect, Devotion to Duty.” I’m not exactly certain what you have, beyond stories that don’t even involve your own suffering.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 30, 2020, 11:23:25 PM
I’m not exactly certain what you have, beyond stories that don’t even involve your own suffering.

I have an insistence that we flatten the curve and fund healthcare like a first world country.

As for my own suffering, I didn't choose to be a cop, a soldier, or a nurse; but give me 18 months and I might have some stories of my own, or I might be dead, or I might have permanent lung damage. Because as MoseyingAlong pointed out, all of society is going through this right now.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on March 31, 2020, 01:15:42 AM
Yeah....no.
I, and I'd guess all my nursing school classmates, anticipated rough shifts and busy months but "years of pure hell"...no.

Did they miss the last 300 years of history in high-school and college? Because I had to take a full year of history for my BS.*

My family lost people in the 1918 pandemic. Other parts of my family lived through the western front of WWII and the Chinese civil war. I reject the premise that today's generations could have reasonably expected to not have to live through any similar events.


When we were in the military, sure, bring it on.
Civilian healthcare, not government, yeah...no.

There's a difference between a society going thru something and expecting individuals to go thru a specific type of hell.

I don't think there is. You pay a price for living in a society, but the pay offs are huge. The price is that you have to moderate your behaviour for the sake of everyone. We do it all the time - by not stealing and murdering, by queuing in a socially agreed fashion, by being courteous when it comes to how/where we cough, spit, sneeze, pee etc etc. Quarantine is really no different.
Title: Re: How long can we wait while flattening the curve?
Post by: runbikerun on March 31, 2020, 02:21:09 AM
"Suck it up, you knew going in that we might suffer a generation-defining pandemic that would probably leave you with PTSD and kill a sizeable minority of your colleagues" seems like a great way to make sure you have a recruitment crisis in your healthcare system for the next thirty years.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 31, 2020, 06:55:14 AM
Of course people know bad things are coming.

Over the course of a 15 year career, I’ve responded to six hurricanes, and one earthquake. Haiti, Katrina, Maria, Michael, Florence, Dorian. Each response left me with something that will never leave my brain. Haiti above all. The saving grace is that I’ve been able to spread those moments out across 15 years, with gaps in between.

You’re asking medical workers to live disaster response day, after day, after day, for an untold amount of time. To use your analogy: it’s asking a LEO to shoot someone in the line of duty every day, and telling them it’s just part of their job. It’s an astonishing lack of compassion.

@Abe has “First Do No Harm.” @MoseyingAlong has a vocation that stretches back as far as humans. I have “Honor, Respect, Devotion to Duty.” I’m not exactly certain what you have, beyond stories that don’t even involve your own suffering.

Just wanted to voice publicly that I'm grateful we've had you out there @Sailor Sam doing what you do for the past decade and a half.
~n~
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 31, 2020, 08:33:28 AM
"Suck it up, you knew going in that we might suffer a generation-defining pandemic that would probably leave you with PTSD and kill a sizeable minority of your colleagues" seems like a great way to make sure you have a recruitment crisis in your healthcare system for the next thirty years.

That's what I said on page 3:

Some of those people who will die will be healthcare professionals. If the hospitals are overrun there will be MDs and RNs with PTSD and the ones that have the resources to retire early will. People are already talking about a major healthcare professional shortage a year from now.

But other than flattening the curve, getting them supplies, paying them well, and treating the PTSD what do you want me to do? Self immolate at home so that they don't need to see me?
Title: Re: How long can we wait while flattening the curve?
Post by: ender on March 31, 2020, 08:43:09 AM
I'm surprised how much excess in the system people think there is for handling people getting sick and/or dying.

It doesn't take much to upset systems that have slowly gone to equilibrium over many years. It's not like funeral homes and mortuaries have built out a massive amount of additional capability that sits idle for 99% of the time.  Or hospitals for that matter.

Quickly Googling suggests that NYC sees around 420 deaths a day on average. This article (https://nypost.com/2020/03/30/fema-sending-refrigerated-trucks-to-new-york-city-for-covid-19-bodies/) says they had a total of 900 morgue spaces in the entire city. As best I can tell, over 100 people died from Sunday to Monday - even if it's "just" 100 people day dying from covid-19, that's still 25% more deaths and bodies to deal with than normal.

I highly doubt all the systems like funeral homes/etc have 25%+ unused capacity.
Title: Re: How long can we wait while flattening the curve?
Post by: Freedom2016 on March 31, 2020, 08:52:34 AM
Yeah....no.
I, and I'd guess all my nursing school classmates, anticipated rough shifts and busy months but "years of pure hell"...no.

Did they miss the last 300 years of history in high-school and college? Because I had to take a full year of history for my BS.*

My family lost people in the 1918 pandemic. Other parts of my family lived through the western front of WWII and the Chinese civil war. I reject the premise that today's generations could have reasonably expected to not have to live through any similar events.


When we were in the military, sure, bring it on.
Civilian healthcare, not government, yeah...no.

There's a difference between a society going thru something and expecting individuals to go thru a specific type of hell.

I don't think there is. You pay a price for living in a society, but the pay offs are huge. The price is that you have to moderate your behaviour for the sake of everyone. We do it all the time - by not stealing and murdering, by queuing in a socially agreed fashion, by being courteous when it comes to how/where we cough, spit, sneeze, pee etc etc. Quarantine is really no different.

This reply seems to miss the point -- that MEDICALLY TRAINED individuals are being expected to go thru a specific type of hell.

For my family, self-isolation/quarantine is inconvenient but a far cry from hell.
Title: Re: How long can we wait while flattening the curve?
Post by: PDXTabs on March 31, 2020, 09:25:56 AM
I highly doubt all the systems like funeral homes/etc have 25%+ unused capacity.

We're lucky that we have refrigeration trucks. There were no refrigeration trucks in 1918 (https://www.history.com/this-day-in-history/flu-epidemic-hits-philadelphia). In Italy the military is driving bodies to the crematoriums that still have capacity (https://www.businessinsider.com/coronavirus-italy-army-transport-coffins-bergamo-morgue-crisis-video-2020-3) and has banned funerals (https://www.cbsnews.com/news/italy-has-banned-funerals-now-after-coronavirus-patients-die-alone-they-are-buried-alone-too/).
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 31, 2020, 10:11:32 AM
just tossing two things out there.  File under: Procedural Uncertainties

1) my sister (physician) has been redirected from her normal medical duties to assessing possible COVID patients in their cars in a parking garage 2x/week and handing overflow patients remotely the remaining days. Like much of the medical profession, her pay is normally tied to how many patients she sees in office and clinic hours.  Now that she's outside that normal billing schedule no one in her practice has any idea how or what they will be paid this coming period.  Meanwhile, her workload, risk-exposure and stress-level has gone through the roof.

2) my father (physican, retired several years ago) might be "recalled" to treat 'everyday' patients while younger, current doctors take care of suspected COVID patients.  There's no modern precedent for this in his career.  While he's confident in his ability to practice medicine, there's a lot of legal uncertainty here -- he no longer carries malpractice insurance and as he retired several years ago his board certification is no longer up to date.  So where does that leave him (and patients) who come in with a sprained ankle or complications from chronic illnesses... what happens when the person treating and potentially prescribing medicine is an uninsured former doctor?

...uncertain times.
Title: Re: How long can we wait while flattening the curve?
Post by: Luz on March 31, 2020, 11:20:03 AM
Realizing that the original post was on March 17... a lot has happened since then. 
  • There's currently 45 refrigerated trailers parked in NYC for dealing with COVID-19 deaths.
  • I work in the medical-industrial complex, and my industry is scrambling to figure out how to supply hundreds of thousands of ventilators to keep people alive.
  • Medical professionals are scared, overwhelmed, but still showing up (thank you).
  • In general, you're better off the younger you are, but there's also plenty of counter-examples who that hasn't worked out for.

As painful as it is to shut everything down, I'm not really seeing the alternative.

I think the alternative is long gone and at this point, it's really the only option.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 31, 2020, 11:42:17 AM
But we haven't shut everything down. Does anyone live someplace where everything is shut down? NYC didnt look shutdown yesterday with the crowds watching the navy hospital ship arrive.

Where I live we have a "stay at home order" but there are so many exceptions that virtually the only people affected are restaurant servers, massager, and hair stylists. pretty much everything else is deemed "essential".
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 31, 2020, 11:48:23 AM
But we haven't shut everything down. Does anyone live someplace where everything is shut down? NYC didnt look shutdown yesterday with the crowds watching the navy hospital ship arrive.

Where I live we have a "stay at home order" but there are so many exceptions that virtually the only people affected are restaurant servers, massager, and hair stylists. pretty much everything else is deemed "essential".

There's "shut down" and then there's "forced isolation" (akin to home arrest). Here in the US we haven't gone towards the latter, at least not yet.
Still, with almost all front-facing businesses closed, as well as schools and (most) daycare the number of person-to-person interactions have plummeted for most people.  My wife and have gone for a full week without ever coming within 6' of another person, even though we still go for long walks every day.
Title: Re: How long can we wait while flattening the curve?
Post by: Wolfpack Mustachian on March 31, 2020, 11:56:54 AM
I’m not exactly certain what you have, beyond stories that don’t even involve your own suffering.

I have an insistence that we flatten the curve and fund healthcare like a first world country.

As for my own suffering, I didn't choose to be a cop, a soldier, or a nurse; but give me 18 months and I might have some stories of my own, or I might be dead, or I might have permanent lung damage. Because as MoseyingAlong pointed out, all of society is going through this right now.

I'm not sure what you're trying to get at with all of this, but the only thing that's coming off to me is a complete lack of any attempt at empathy. These people didn't enlist in an army. They went and got a college degree and took jobs with the desire to help people. What they've been put in is far worse than anyone would have expected. My spouse is in the medical field working in a hospital. Things aren't bad here yet, but even with that, the tension is high. I don't really care if they "should have known" it was a possibility or not, the least you can do with people who are literally giving their lives to help others is try to not come off like you are.... In 18 months, you might have some stories of your own, and if you do, I'll try to empathize with you about them.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on March 31, 2020, 12:11:56 PM
The way modern forced indenture works is you set up the rules so that people have to work or they die.

For example grocery worker needs the money from the job for food and shelter and the health insurance. Only those who get fired can get unployment benefits. Healthcare workers are no different, I'm sure many of them would change careers right now if they could.

Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on March 31, 2020, 12:12:17 PM
2) my father (physican, retired several years ago) might be "recalled" to treat 'everyday' patients while younger, current doctors take care of suspected COVID patients.  There's no modern precedent for this in his career.  While he's confident in his ability to practice medicine, there's a lot of legal uncertainty here -- he no longer carries malpractice insurance and as he retired several years ago his board certification is no longer up to date.  So where does that leave him (and patients) who come in with a sprained ankle or complications from chronic illnesses... what happens when the person treating and potentially prescribing medicine is an uninsured former doctor?

...uncertain times.

Would problems here be covered by some sort of Good Samaritan law?
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 31, 2020, 12:19:50 PM
2) my father (physican, retired several years ago) might be "recalled" to treat 'everyday' patients while younger, current doctors take care of suspected COVID patients.  There's no modern precedent for this in his career.  While he's confident in his ability to practice medicine, there's a lot of legal uncertainty here -- he no longer carries malpractice insurance and as he retired several years ago his board certification is no longer up to date.  So where does that leave him (and patients) who come in with a sprained ankle or complications from chronic illnesses... what happens when the person treating and potentially prescribing medicine is an uninsured former doctor?

...uncertain times.

Would problems here be covered by some sort of Good Samaritan law?

No idea.  Typically (as I've learned in first-responder training) good Samaritan laws are applicable up to your current standard of training.  So if I'm trained in CPR and I see someone who I think might need CPR  and I administer CPR I'm covered, even if "bad things happen" as a result of my actions.  But if I try to perform a tracheostomy but have no surgical training... then I'm in big legal trouble.

As someone who practiced medicine for almost 40 years, my father knows that you aren't supposed to practice medicine unless you are current with your training (e.g. boards).  So... he's being asked to do something he was trained for, but for which he knows under normal circumstances he should not do anymore. 

Love to hear a legal opinion on this though...
Title: Re: How long can we wait while flattening the curve?
Post by: Cassie on March 31, 2020, 12:34:53 PM
Neeeo, surely this would be voluntarily on your Dad’s part. He is older so in a high risk group. What a dilemma. My heart aches for the medical staff and the least we all can do is keep our asses home.
Title: Re: How long can we wait while flattening the curve?
Post by: secondcor521 on March 31, 2020, 12:39:49 PM
@nereo, in normal times I doubt any physician would practice medicine without adequate malpractice insurance, and in normal times I think all malpractice insurance requires the doctor to be current on boards, state licensure, and any other sort of requirements like that.

In non-normal times, I don't know what the answer is, but the malpractice aspect is something that I think most doctors would insist on being addressed before moving forward.  Some sort of blanket law protecting them might work (like the Volunteer Protection Act or similar).
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on March 31, 2020, 12:46:38 PM
Neeeo, surely this would be voluntarily on your Dad’s part. He is older so in a high risk group. What a dilemma. My heart aches for the medical staff and the least we all can do is keep our asses home.

To be clear, it seems that they want these recently retired physicians to take non-COVID cases, freeing up the younger doctors and health care professionals to deal with the very infectious stuff.  He'd basically be handling the caseload of patients that need weekly/monthly appointments for chronic conditions, as well as seeing acute, non-infectious patients (e.g. "I fell off a ladder yesterday and now my chest hurts").
Title: Re: How long can we wait while flattening the curve?
Post by: skp on March 31, 2020, 01:14:11 PM
Neeeo, surely this would be voluntarily on your Dad’s part. He is older so in a high risk group. What a dilemma. My heart aches for the medical staff and the least we all can do is keep our asses home.

To be clear, it seems that they want these recently retired physicians to take non-COVID cases, freeing up the younger doctors and health care professionals to deal with the very infectious stuff.  He'd basically be handling the caseload of patients that need weekly/monthly appointments for chronic conditions, as well as seeing acute, non-infectious patients (e.g. "I fell off a ladder yesterday and now my chest hurts").

I'm a nurse and just throwing this idea out.  I wonder if people like your father who are no longer credentialed, with no malpractice insurance, could function like a NP or PA, under the supervision of a credentialed MD.
I'm an ICU nurse.  My facility is planning for an onslaught of vent patients with not enough ICU staff by  training our stepdown nurses in basic vent management and ICU skills. Most of them have already been taking chronic stable vent patients.  We've been training them over the last month while our census is low instead of calling people off.  Obviously they aren't going to know everything they need to know, but the plan is to have them take the vented covid patients under the supervision of an ICU nurse.  Each med surg/ step down nurse can handle 2 or 3 patients.   And 3 of them will be supervised by ICU nurses. 
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on March 31, 2020, 02:40:57 PM
Yeah....no.
I, and I'd guess all my nursing school classmates, anticipated rough shifts and busy months but "years of pure hell"...no.

Did they miss the last 300 years of history in high-school and college? Because I had to take a full year of history for my BS.*

My family lost people in the 1918 pandemic. Other parts of my family lived through the western front of WWII and the Chinese civil war. I reject the premise that today's generations could have reasonably expected to not have to live through any similar events.


When we were in the military, sure, bring it on.
Civilian healthcare, not government, yeah...no.

There's a difference between a society going thru something and expecting individuals to go thru a specific type of hell.

I don't think there is. You pay a price for living in a society, but the pay offs are huge. The price is that you have to moderate your behaviour for the sake of everyone. We do it all the time - by not stealing and murdering, by queuing in a socially agreed fashion, by being courteous when it comes to how/where we cough, spit, sneeze, pee etc etc. Quarantine is really no different.

This reply seems to miss the point -- that MEDICALLY TRAINED individuals are being expected to go thru a specific type of hell.

For my family, self-isolation/quarantine is inconvenient but a far cry from hell.

Isolation might well become your personal hell if you had family members that died and you were unable to see them or say goodbye before they did. Or if you had to give birth without a support person. Or a hundred other circumstances. We are all being asked to give something up. Medical staff are obviously on the front line and their struggle is much more immediate and obvious - and we know they're heroes to do this for us all. Luckily for the rest of us, most medical staff are the giver/helper type who run towards these situations rather than away. Yes, there's an expectation that they do their bit. The same expectation is on all of us. Our bit is just a lot smaller.
Title: Re: How long can we wait while flattening the curve?
Post by: Just Joe on March 31, 2020, 08:50:00 PM
Why is isolation such a burden for people.

Isolation in a tin roof shanty with no sanitary facilities - okay!

Isolation in a dry, heated/cooled western home with electricity and running water likely with TV and internet? What IS the problem?

We've really enjoyed time at home despite the worries about this virus. Its been a staycation. Games, TV, music, books, good food, and chores. Also - hobbies.
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on April 01, 2020, 02:40:36 AM
I'm surprised how much excess in the system people think there is for handling people getting sick and/or dying.
Indeed. For wars we have this absolutely massive military that's being kept around "just in case", basically doing nothing but training. (Ok they're not doing quite as much nothing as I would like, but pretty close compared to a full-out major conflict. People are arguing about the size of the military but at most they want to cut it by tens of percent.)

Why are we OK with the country not having a similar "force readiness" when it comes to health care? It's not just for pandemics either, if there really was to be a major military conflict on US soil the health care system wouldn't stand a chance.

We have better responses to natural disasters, but those happen so often somewhere that they're not really "kept around doing nothing" that it's sort of in a different regime.
Title: Re: How long can we wait while flattening the curve?
Post by: Travis on April 01, 2020, 04:56:23 AM
I'm surprised how much excess in the system people think there is for handling people getting sick and/or dying.
Indeed. For wars we have this absolutely massive military that's being kept around "just in case", basically doing nothing but training. (Ok they're not doing quite as much nothing as I would like, but pretty close compared to a full-out major conflict. People are arguing about the size of the military but at most they want to cut it by tens of percent.)

Why are we OK with the country not having a similar "force readiness" when it comes to health care? It's not just for pandemics either, if there really was to be a major military conflict on US soil the health care system wouldn't stand a chance.

We have better responses to natural disasters, but those happen so often somewhere that they're not really "kept around doing nothing" that it's sort of in a different regime.

Worth mentioning that the hospital ship in NYC (of which there are only two) will be seeing non-COVID patients to take some of the burden off the civilian infrastructure. The Army's hospital units have been constructing field sites in a few places around the country to take on additional patients.  The Army has a dozen or so deployable field hospitals in the force. Each is capable of handling about 400 patients depending on their needs. A typical field hospital can perform primary care functions, some imaging, some surgeries, but a patient is expected to be moved on within 3 days to a higher level of care.  The catch is that most of the docs and nurses in these units have day jobs in the Army's garrison hospitals. A surgeon stitching up a bullet wound in Afghanistan for 9-12 months is not stitching up a training accident victim at Fort Hood where he normally works. Most of our deployable medical capability is in the Reserves which means most credentialed soldiers have civilian medical day jobs.  We can't tap them for this emergency. The Army reached out to the recently retired community to see if anybody would be willing to come back on active duty for some unspecified amount of time (as long as they're not already committed to a civilian medical occupation).  There's also talk of making the call up involuntary if the need is great enough.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 01, 2020, 06:57:52 AM
Why is isolation such a burden for people.

Isolation in a tin roof shanty with no sanitary facilities - okay!

Isolation in a dry, heated/cooled western home with electricity and running water likely with TV and internet? What IS the problem?

We've really enjoyed time at home despite the worries about this virus. Its been a staycation. Games, TV, music, books, good food, and chores. Also - hobbies.

For us it's the compounding problem of being required to work from home while raising a toddler in a confined space with no day care or external support. 
That is crushing, for us.  Our daughter doesn't understand why she can't see her friend across the yard, or play at daycare or use the playground (now encased in 'Police Tape'), her world has been confined to a few rooms and walks around the block.

At the same time we both must work, but with many of the necessary tools (physical and virtual) less available to us.  Wife spends 4-5 hours in virtual meetings each day but document sharing is incredibly problematic... she can't just scan, print and share with everyone.  Lots of the people she's meeting with lack strong internet connections and/or technical saavy.  Every 'meeting' begins with several minutes of group tech-support and inevitably at least one or two people are listening on cellphones, unable to fully participate.  Accessing the secure server isn't an option, so files have to made through special requisitions made to the poor IT guys that are still in the building.... which is a lot like asking someone else to locate an item in your home...

I'm furloughed but still expected/requires to perform many of my duties, particularly to my students.  That's particularly frustrating knowing I have an obligation to do quality work but will not ever be compensated for the time I spend now.

Then there;'s the very heavy emotional toll, which neither of us really expected.  We have elderly parents who we can't see, and who can't see their grandchildren.  Spouse has a frail grandfather who very could pass away before we're allowed to visit.  I have three family members working on the front lines of COVID and I know their exposure risk is sky-high.  And then there's all the other close friends we can't physically be there for; my friend recovering from a divorce, my BIL who's struggling with a colicky infant, etc.  Video chat is good, but it's hard when you know there's no way you can actually be there in person.

In short - we've never had so much on our plate for so little compensation or support.
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on April 01, 2020, 07:30:04 AM
Why is isolation such a burden for people.

Isolation in a tin roof shanty with no sanitary facilities - okay!

Isolation in a dry, heated/cooled western home with electricity and running water likely with TV and internet? What IS the problem?

We've really enjoyed time at home despite the worries about this virus. Its been a staycation. Games, TV, music, books, good food, and chores. Also - hobbies.

For us it's the compounding problem of being required to work from home while raising a toddler in a confined space with no day care or external support. 
That is crushing, for us.  Our daughter doesn't understand why she can't see her friend across the yard, or play at daycare or use the playground (now encased in 'Police Tape'), her world has been confined to a few rooms and walks around the block.

At the same time we both must work, but with many of the necessary tools (physical and virtual) less available to us.  Wife spends 4-5 hours in virtual meetings each day but document sharing is incredibly problematic... she can't just scan, print and share with everyone.  Lots of the people she's meeting with lack strong internet connections and/or technical saavy.  Every 'meeting' begins with several minutes of group tech-support and inevitably at least one or two people are listening on cellphones, unable to fully participate.  Accessing the secure server isn't an option, so files have to made through special requisitions made to the poor IT guys that are still in the building.... which is a lot like asking someone else to locate an item in your home...

I'm furloughed but still expected/requires to perform many of my duties, particularly to my students.  That's particularly frustrating knowing I have an obligation to do quality work but will not ever be compensated for the time I spend now.

Then there;'s the very heavy emotional toll, which neither of us really expected.  We have elderly parents who we can't see, and who can't see their grandchildren.  Spouse has a frail grandfather who very could pass away before we're allowed to visit.  I have three family members working on the front lines of COVID and I know their exposure risk is sky-high.  And then there's all the other close friends we can't physically be there for; my friend recovering from a divorce, my BIL who's struggling with a colicky infant, etc.  Video chat is good, but it's hard when you know there's no way you can actually be there in person.

In short - we've never had so much on our plate for so little compensation or support.

+1


I'm required to do the same amount of work as I would do at the office, but there are a variety of things that now slow me down.  That means I've been averaging 10 - 11 hours a day and working on the weekends to try to make up time.  In addition to that, my wife has a similar working situation, and we're trying to educate our six year old for eight hours a day while doing this.  In addition to that, I have to plan out and figure what time during the week will be the safest to take 2-3 hours to try to buy groceries (can't go on the weekend because of food shortages and large crowds).

My wife's parents are in the Philippines, and my parents are here in Canada.  All the parents are in a high risk group for one reason or another, and I'm really hoping that they all come out OK, which is adding to the stress.  After being screamed at by a passing person in a car the other day that I needed to be inside my home or he would run me off the road if he saw me again . . . it seems like I'm going to lose my primary exercise outlet too.

It's good that many people are having themselves a fun government paid vacation/party, but some of us have got significantly less free time and a hell of a lot more stress.  (Although, nereo has it worse than me . . . at least I'm paid for my work.)
Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on April 01, 2020, 07:34:04 AM
I'm surprised how much excess in the system people think there is for handling people getting sick and/or dying.
Indeed. For wars we have this absolutely massive military that's being kept around "just in case", basically doing nothing but training. (Ok they're not doing quite as much nothing as I would like, but pretty close compared to a full-out major conflict. People are arguing about the size of the military but at most they want to cut it by tens of percent.)

Why are we OK with the country not having a similar "force readiness" when it comes to health care? It's not just for pandemics either, if there really was to be a major military conflict on US soil the health care system wouldn't stand a chance.

We have better responses to natural disasters, but those happen so often somewhere that they're not really "kept around doing nothing" that it's sort of in a different regime.
I look at it in terms of my home and life it is only realistic to plan / prepare to a certain level. I suppose you could prepare for every single possibility but I do not have the space, time or capital to prepare for every possibility so I make a decision on the probability of necessity and go with that.

So if Yellowstone goes super volcano I might not be prepared and die, if a nuke gets dropped close enough to Colorado I might not be prepared and die.

I prepare for prolonged snow storms, fires, lack of services and things that are more likely. If something else happens we try to adapt and react as best as we can.


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Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on April 01, 2020, 07:37:39 AM
@nereo

If you are furloughed why are you still working?

I would tell my work to pound sand if they wanted to furlough me, not pay me and expect anything from me.

Probably even against the law I would suspect


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Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 01, 2020, 09:15:55 AM
My position has mostly shifted to this:

We need to increase testing, production of PPE, and healthcare capacity at basically a military/WW2 style level.  Basically have the entire country dedicated to this effort in April.

Once that is accomplished, we have to open society back up, institute smart safety protocols (wearing of masks, isolation of most vulnerable, quarantine procedure for infected), and just accept the consequences.  We cannot dedicate our entire economy and society to defeating this virus, because the long term economic and public health damage will exceed anything the virus would do.

I simply do not think people are thinking long term here.  A Great Depression means loss of jobs for our lower/middle class, homelessness, hunger, increase in suicides, mental health damage, etc.  Please do not show me your study about an increase in life expectancy during the Depression.  Life was fucking terrible for a long time and it took WW2 to get us out of that mess.

The "flatten the curve" mantra cannot go on forever.  It is a way to buy time to increase capacity.  Beyond that, we as a society need to move on.
Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on April 01, 2020, 09:23:56 AM
I mean, that is the actual plan - bring the hammer for a few / weeks maybe months. Once it is under control enough, and capacity like you've described increases, we shift to the dance - start getting back to normal, but with good surveillance basically play whack-a-mole. Layed out here almost 2 weeks ago..

https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56

Social distancing / shutdowns were never intended to be forever.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 01, 2020, 09:31:39 AM
@nereo

If you are furloughed why are you still working?

I would tell my work to pound sand if they wanted to furlough me, not pay me and expect anything from me.

Probably even against the law I would suspect


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Two reasons. I’m an adjunct faculty and researcher. While my party is tied entirely to the number of course hours taught (currently zero as campus - and in particular all labs - are closed) I’m also an advisor to several students. This would fall under my normal workload and I don’t think it’s fair for me not to continue to advise students who are already getting the short end of the stick

At the same time we are working to publish several papers from a grant which wrapped up last fall. Grants rarely cover time for the required publication - the hope is that you continue to work on new projects while finishing up previous ones. But those have stopped too, as all field work has been canceled.

This situation has really exposed a lot of the weaknesses in our funding model for higher education.
Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on April 01, 2020, 09:41:13 AM
Fair enough, I guess they are not forcing you to work you are choosing to do it so doubt any laws are being broken.

I think we all do that at one point or another in life so we do not fall behind, to get ahead or we just think it is the right thing to do.


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Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 01, 2020, 09:53:02 AM
Fair enough, I guess they are not forcing you to work you are choosing to do it so doubt any laws are being broken.

I think we all do that at one point or another in life so we do not fall behind, to get ahead or we just think it is the right thing to do.

In a sense this is true - no one is "forcing" me to work.  However, the way the system is set up if I don't do this work I will almost certainly not be hired back.
In academia your value is measured by your output.  Primarily publications but also the number of students you have advised, community seminars given, etc.

As an adjunct (the educational word for "contract employee" you are only paid for course hours taught. You do not get paid for prep time, or for your office hours, or the papers you must publish or the seminars you are asked to give.  Under normal circumstances this works out ok (... but certainly not great).  under current circumstances I have all these things which I'm still expected to accomplish, but which do not result in any paid work.

I've already promised students I would serve on their committee, so I don't feel ok backing out of that promise.  And there's requriements on all grants to show 'quality output' - but again that's not anything you are paid for, it's just expected, and very very often done after the grant funding has expired.  If I don't do it, I will torpedo my own chances of getting future grants, and be uncompetitive for future faculty or researcher positions.

Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on April 01, 2020, 09:58:15 AM
I don't understand how anyone puts up with academia BS, and yet there never seems to be a shortage of professors desperate for work. Seems ripe for an organized labor movement.

I'm sure it is a nuanced thing that I'll never fully understand, but it just seems like such a raw deal for the effort it takes.
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on April 01, 2020, 09:59:56 AM
I don't understand how anyone puts up with academia BS, and yet there never seems to be a shortage of professor's desperate for work. Seems ripe for an organized labor movement.

I'm sure it is a nuanced thing that I'll never fully understand, but it just seems like such a raw deal for the effort it takes.

It's why I bailed after my postdoc. It's a horribly exploitative system.
Title: Re: How long can we wait while flattening the curve?
Post by: bilmar on April 01, 2020, 10:06:32 AM
I think many are mistaking the choice as between flattening the curve  and saving the economy.

I don't see the economy recovering UNTIL people stop being scared of ending up in hospital which will likely be based on reports of the state of their local hospitals' capacity, shortages of PPE, machines, staff etc  and local infection/death rates.


Here is a reasonable thought experiment ( for USA):
Assume that social distancing rules remains spotty with thousands of cars driving between cities and communities every day so the virus eventually spreads to every community in the USA.
In the next 6 weeks,  hospitals across the nation run at or beyond capacity for months after with no elective surgery - even in small towns.

Further assume that we are told by White House  that 'people die, deal with it and go stimulate the economy'.

If Joe Public believes that his local hospital is a death trap and that there is a serious risk of ending up there if he does go out to to the restaurant, will he do so anyway?
Will that worry cause him to not buy that new sofa, car etc and instead save some money just in case?


In normal times, the state of the US economy has always been driven by consumer confidence.
Why should now be any different?


Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 01, 2020, 10:12:30 AM
I don't understand how anyone puts up with academia BS, and yet there never seems to be a shortage of professor's desperate for work. Seems ripe for an organized labor movement.

I'm sure it is a nuanced thing that I'll never fully understand, but it just seems like such a raw deal for the effort it takes.

It is a raw deal.  This may sound corny but I do it because I love to teach, and I love to do primary research, and this is the only avenue one really has to do such things.

Things for academics got a lot worse during and immediately after the 'Great Recession'.  Every single state was forced to cut direct funding to higher education, and federal funding took a big hit as well.  For many large university systems the funding has yet to recover to pre-2008 levels, even as enrollment has increased.

The GOP has continued to push "challenge based grants" designed to "reward excellence" and "promote the best and brightest".  Sounds good in a sound byte but you can't just reward the A-level professors and students.  Those B+ to C- folks need resources too, and more importantly higher education systems need to have a steady stream of income to form budget and long-term plans.  So they've done what the 'free-market' dictates... jack up tuition to unsustainable levels (reliable source of revenue) and paid top-dollar to secure A+ faculty that will bring in the huge grants that drive overhead.  It makes the business of education run, but it's not in the best interest of the middle 50% (or so) of students or faculty that are highly competent and bright but not 'superstars'.  And its downright awful for the bottom tier students who struggle, can't get the resources they need but (ironically) can and are encouraged to take out 5-figure student loans.

What irritates the hell out of me is the common opinion by tenured (older) faculty that struggling as an adjunct is a 'rite of passage', and therefor ok. 
Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on April 01, 2020, 10:22:31 AM
I think many are mistaking the choice as between flattening the curve  and saving the economy.

I don't see the economy recovering UNTIL people stop being scared of ending up in hospital which will likely be based on reports of the state of their local hospitals' capacity, shortages of PPE, machines, staff etc  and local infection/death rates.


Here is a reasonable thought experiment ( for USA):
Assume that social distancing rules remains spotty with thousands of cars driving between cities and communities every day so the virus eventually spreads to every community in the USA.
In the next 6 weeks,  hospitals across the nation run at or beyond capacity for months after with no elective surgery - even in small towns.

Further assume that we are told by White House  that 'people die, deal with it and go stimulate the economy'.

If Joe Public believes that his local hospital is a death trap and that there is a serious risk of ending up there if he does go out to to the restaurant, will he do so anyway?
Will that worry cause him to not buy that new sofa, car etc and instead save some money just in case?


In normal times, the state of the US economy has always been driven by consumer confidence.
Why should now be any different?
After enough time passes I think most people would resume their old habits even if risking death but it would be a while for it to become the new norm.

The economy would still be in a world of hurt and in my opinion it would be worse off.

Probably the best thing they could have done for the economy would have been a Wuhan style lock down plus a serious quarantine of people coming back so we could get past it ASAP and restart the economy.

That would never fly in the US so we either take it slow and ask people to social distance and stay home or just let it rip.

As soon as the president even mentioned putting a quarantine in place is was called an act of war against NY and people were pissed.

Now imagine them trying to do that to the entire country if the place that is on fire acts that way.


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Title: Re: How long can we wait while flattening the curve?
Post by: Cassie on April 01, 2020, 10:27:58 AM
I didn’t spend my career in higher education but teach a online college class every semester for the past 8 years. I get paid for teaching but keep it updated for free. Some people say they wouldn’t do that but if I don’t I will lose the class. I really feel sorry for people working full time from home with kids that need home schooling now. I am sure the kids are also suffering from the isolation. We are in a high risk group and my kids are worried. It really sucks not to be able to hang out with family and friends. People are dying alone in hospitals and women are giving birth alone. Really stressful times.
Title: How long can we wait while flattening the curve?
Post by: the_fixer on April 01, 2020, 10:33:06 AM
Fair enough, I guess they are not forcing you to work you are choosing to do it so doubt any laws are being broken.

I think we all do that at one point or another in life so we do not fall behind, to get ahead or we just think it is the right thing to do.

In a sense this is true - no one is "forcing" me to work.  However, the way the system is set up if I don't do this work I will almost certainly not be hired back.
In academia your value is measured by your output.  Primarily publications but also the number of students you have advised, community seminars given, etc.

As an adjunct (the educational word for "contract employee" you are only paid for course hours taught. You do not get paid for prep time, or for your office hours, or the papers you must publish or the seminars you are asked to give.  Under normal circumstances this works out ok (... but certainly not great).  under current circumstances I have all these things which I'm still expected to accomplish, but which do not result in any paid work.

I've already promised students I would serve on their committee, so I don't feel ok backing out of that promise.  And there's requriements on all grants to show 'quality output' - but again that's not anything you are paid for, it's just expected, and very very often done after the grant funding has expired.  If I don't do it, I will torpedo my own chances of getting future grants, and be uncompetitive for future faculty or researcher positions.
I get it, my wife works in the scientific community for the federal government and a large part of their work is with and at universities on projects that will probably not come to fruition until long after she retires and in some cases is dead.

During the shutdown last year people @ her work were still working despite not getting paid and even people working under grants from the university were working to move things forward because they wanted to come out of it in a good place for the future.

Granted my wife did get paid after the shutdown while the people working under grants from the university’s were not paid until they made up their “time” despite working.

Personally I choose to work in industry because working for uni or the government has too many downsides.


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Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on April 01, 2020, 04:39:36 PM
I'm required to do the same amount of work as I would do at the office...
You are not required to. None of this is normal and if your employer expects that they, alone among all, should be untouched by this situation, someone needs to set them straight. Even my normally hardcore employer understands that apart from working at home, people are dealing with taking care of kids, etc, and everyone can just do the best they can. Work does not take precedence over everything else in your life, arguably even less so in the current situation.
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on April 01, 2020, 04:44:46 PM
I look at it in terms of my home and life it is only realistic to plan / prepare to a certain level. I suppose you could prepare for every single possibility but I do not have the space, time or capital to prepare for every possibility so I make a decision on the probability of necessity and go with that.

So if Yellowstone goes super volcano I might not be prepared and die, if a nuke gets dropped close enough to Colorado I might not be prepared and die.

I prepare for prolonged snow storms, fires, lack of services and things that are more likely. If something else happens we try to adapt and react as best as we can.
I was not at all arguing that every individual should prep themselves for a societal apocalypse. On the contrary. I was just making the point that it seems to me that having a health care system that maintains a significant surge capacity is just as much a "National Security Issue" as maintaining people with guns beyond the normal police force. You build these systems with the hope that they will never be needed, because the price to society if you find that they are needed and you don't have them is too great.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on April 01, 2020, 04:54:58 PM
I'm required to do the same amount of work as I would do at the office...
You are not required to. None of this is normal and if your employer expects that they, alone among all, should be untouched by this situation, someone needs to set them straight. Even my normally hardcore employer understands that apart from working at home, people are dealing with taking care of kids, etc, and everyone can just do the best they can. Work does not take precedence over everything else in your life, arguably even less so in the current situation.

Oh really??? What country/universe do you live in? This kind of attitude is likely to get one fired, during a time when unemployment is the highest its EVER been in the US. Without a job there is no health insurance and little or no money. Without health insurance there is no COVID treatment and a shortened life of pain, suffering, and bankruptcy is a very high possibility. Id argue that given the current facts of the situation work should take precedence over everything but maintaining your health to the degree that it enables you to continue to perform your work. If anything I think employers now know they have the upper hand, anyone complaining should realize how lucky they are to have a job. Its not all doom and gloom though, this work attitude is going to make us super competitive in the global market, we're going to work our asses off, take less vacation, get paid less, and our companies will do well.


Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on April 01, 2020, 06:39:52 PM
I look at it in terms of my home and life it is only realistic to plan / prepare to a certain level. I suppose you could prepare for every single possibility but I do not have the space, time or capital to prepare for every possibility so I make a decision on the probability of necessity and go with that.

So if Yellowstone goes super volcano I might not be prepared and die, if a nuke gets dropped close enough to Colorado I might not be prepared and die.

I prepare for prolonged snow storms, fires, lack of services and things that are more likely. If something else happens we try to adapt and react as best as we can.
I was not at all arguing that every individual should prep themselves for a societal apocalypse. On the contrary. I was just making the point that it seems to me that having a health care system that maintains a significant surge capacity is just as much a "National Security Issue" as maintaining people with guns beyond the normal police force. You build these systems with the hope that they will never be needed, because the price to society if you find that they are needed and you don't have them is too great.
I understand I was using my personal example to compare why the government can never prepare for every eventual outcome for every situation it is not realistic.


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Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 01, 2020, 06:49:45 PM
I'm required to do the same amount of work as I would do at the office...
You are not required to. None of this is normal and if your employer expects that they, alone among all, should be untouched by this situation, someone needs to set them straight. Even my normally hardcore employer understands that apart from working at home, people are dealing with taking care of kids, etc, and everyone can just do the best they can. Work does not take precedence over everything else in your life, arguably even less so in the current situation.

Oh really??? What country/universe do you live in? This kind of attitude is likely to get one fired, during a time when unemployment is the highest its EVER been in the US. Without a job there is no health insurance and little or no money. Without health insurance there is no COVID treatment and a shortened life of pain, suffering, and bankruptcy is a very high possibility. Id argue that given the current facts of the situation work should take precedence over everything but maintaining your health to the degree that it enables you to continue to perform your work. If anything I think employers now know they have the upper hand, anyone complaining should realize how lucky they are to have a job. Its not all doom and gloom though, this work attitude is going to make us super competitive in the global market, we're going to work our asses off, take less vacation, get paid less, and our companies will do well.

Other countries, perhaps even most other countries have employment laws that protect employees, social welfare nets, and universal healthcare.
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on April 01, 2020, 07:00:20 PM
I'm required to do the same amount of work as I would do at the office...
You are not required to. None of this is normal and if your employer expects that they, alone among all, should be untouched by this situation, someone needs to set them straight. Even my normally hardcore employer understands that apart from working at home, people are dealing with taking care of kids, etc, and everyone can just do the best they can. Work does not take precedence over everything else in your life, arguably even less so in the current situation.

Oh really??? What country/universe do you live in? This kind of attitude is likely to get one fired, during a time when unemployment is the highest its EVER been in the US. Without a job there is no health insurance and little or no money. Without health insurance there is no COVID treatment and a shortened life of pain, suffering, and bankruptcy is a very high possibility. Id argue that given the current facts of the situation work should take precedence over everything but maintaining your health to the degree that it enables you to continue to perform your work. If anything I think employers now know they have the upper hand, anyone complaining should realize how lucky they are to have a job. Its not all doom and gloom though, this work attitude is going to make us super competitive in the global market, we're going to work our asses off, take less vacation, get paid less, and our companies will do well.

Other countries, perhaps even most other countries have employment laws that protect employees, social welfare nets, and universal healthcare.

I work in Canada.  Mostly I'm putting in a lot of extra effort because I don't want to let others down and because if we fail to meet contracts in the near future our company may very well go under.  If all of us drop down to 60-80% of our regular work output, I honestly don't think we'll last very long.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 01, 2020, 07:23:39 PM
I'm required to do the same amount of work as I would do at the office...
You are not required to. None of this is normal and if your employer expects that they, alone among all, should be untouched by this situation, someone needs to set them straight. Even my normally hardcore employer understands that apart from working at home, people are dealing with taking care of kids, etc, and everyone can just do the best they can. Work does not take precedence over everything else in your life, arguably even less so in the current situation.

Oh really??? What country/universe do you live in? This kind of attitude is likely to get one fired, during a time when unemployment is the highest its EVER been in the US. Without a job there is no health insurance and little or no money. Without health insurance there is no COVID treatment and a shortened life of pain, suffering, and bankruptcy is a very high possibility. Id argue that given the current facts of the situation work should take precedence over everything but maintaining your health to the degree that it enables you to continue to perform your work. If anything I think employers now know they have the upper hand, anyone complaining should realize how lucky they are to have a job. Its not all doom and gloom though, this work attitude is going to make us super competitive in the global market, we're going to work our asses off, take less vacation, get paid less, and our companies will do well.

This kind of makes me giggle. It's exactly the attitude that the billionaires want you to have. You're not actually reliant on them, you know. If you want more information, there's this little blog called Mr Money Mustache......
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on April 01, 2020, 07:57:40 PM
Oh really??? What country/universe do you live in? This kind of attitude is likely to get one fired, during a time when unemployment is the highest its EVER been in the US. Without a job there is no health insurance and little or no money. Without health insurance there is no COVID treatment and a shortened life of pain, suffering, and bankruptcy is a very high possibility. Id argue that given the current facts of the situation work should take precedence over everything but maintaining your health to the degree that it enables you to continue to perform your work. If anything I think employers now know they have the upper hand, anyone complaining should realize how lucky they are to have a job. Its not all doom and gloom though, this work attitude is going to make us super competitive in the global market, we're going to work our asses off, take less vacation, get paid less, and our companies will do well.
Unless you work in a shithole, and are a valued employee, I doubt telling your employer that you need some flexibility will get you fired. It's not "an attitude" to (calmly and reasonably, obviously) tell them that you can't do this at this point in time, for obvious reasons.

I don't think it's actually that easy for employers to find new skilled people now; people can't move around, it's hard to conduct interviews when people wfh, and perhaps most of all, the market is about to get flooded with people who are not necessarily the cream of the crop. I remember hearing from my friends who tried to hire people in 2008-2009 that it was actually harder to hire because the applicant pool was diluted with so many unskilled people that finding the skilled ones was even harder than normal.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 02, 2020, 01:10:00 AM
Oh really??? What country/universe do you live in? This kind of attitude is likely to get one fired, during a time when unemployment is the highest its EVER been in the US. Without a job there is no health insurance and little or no money. Without health insurance there is no COVID treatment and a shortened life of pain, suffering, and bankruptcy is a very high possibility. Id argue that given the current facts of the situation work should take precedence over everything but maintaining your health to the degree that it enables you to continue to perform your work. If anything I think employers now know they have the upper hand, anyone complaining should realize how lucky they are to have a job. Its not all doom and gloom though, this work attitude is going to make us super competitive in the global market, we're going to work our asses off, take less vacation, get paid less, and our companies will do well.
Unless you work in a shithole, and are a valued employee, I doubt telling your employer that you need some flexibility will get you fired. It's not "an attitude" to (calmly and reasonably, obviously) tell them that you can't do this at this point in time, for obvious reasons.

I don't think it's actually that easy for employers to find new skilled people now; people can't move around, it's hard to conduct interviews when people wfh, and perhaps most of all, the market is about to get flooded with people who are not necessarily the cream of the crop. I remember hearing from my friends who tried to hire people in 2008-2009 that it was actually harder to hire because the applicant pool was diluted with so many unskilled people that finding the skilled ones was even harder than normal.

I disagree with your premise @lutorm.
For many, many people, they work for businesses that are currently furloughing and laying off workers as they are forced to close and productivity & revenue has already ground to a crawl.  If someone comes up to management and says “I need greater flexibility” that person is very likely to be on the next list of layoffs.  From a practical standpoint, what many businesses need is survive is to quickly slash their payroll and to retain only the bare minimum which might allow them to putter along until this opens back up in a few months.

Because we’ve tied health care to businesses and burdened them with the cost it’s expensive to keep many employees on payroll even when hours are cut. While I agree that managers and owners want to do good by their employees, many businesses are currently undergoing a solvency crisis.  When it comes down to trying to save the company or favor the employee it’s a clear (but unfortunate) choice - if the business fails then all employees and profits are lost permanently. 
Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on April 02, 2020, 01:15:11 AM
^ agreed.

i'm a senior engineer in my 15 person office. i lead the day to day office management and most engineers report to me. i am worried that i will be outworked by the younger engineers because they're single/young and don't have kids. i normally stick to 40 hour weeks, though for the past half year, am around 60 hour weeks.

the shit will hit the fan soon for our industry and the day of reckoning will come. while under almost all of my previous theorized circumstances i think i would've been safe, this disruption to the economy is something completely different.
Title: Re: How long can we wait while flattening the curve?
Post by: Bettersafe on April 02, 2020, 02:15:06 AM
@nereo, in normal times I doubt any physician would practice medicine without adequate malpractice insurance, and in normal times I think all malpractice insurance requires the doctor to be current on boards, state licensure, and any other sort of requirements like that.

In non-normal times, I don't know what the answer is, but the malpractice aspect is something that I think most doctors would insist on being addressed before moving forward.  Some sort of blanket law protecting them might work (like the Volunteer Protection Act or similar).

My legal insurance company stated that any physician going back to work as a result of Corona is covered as if they were still on insurance. But it's an issuance company that only handles healthcare customers so they might have a different reaction than insurance company's that provide non-medical persons as well. And I'm not in the USA, don't know how other countries are responding.
Our government decided any healthcare worker that stoped practicing after jan 1st 2018 could get back to work under supervision. If you go back as a retired doctor you'll basicly be working as a resident again.
Title: Re: How long can we wait while flattening the curve?
Post by: Bettersafe on April 02, 2020, 02:59:08 AM
Of course people know bad things are coming.

Over the course of a 15 year career, I’ve responded to six hurricanes, and one earthquake. Haiti, Katrina, Maria, Michael, Florence, Dorian. Each response left me with something that will never leave my brain. Haiti above all. The saving grace is that I’ve been able to spread those moments out across 15 years, with gaps in between.

You’re asking medical workers to live disaster response day, after day, after day, for an untold amount of time. To use your analogy: it’s asking a LEO to shoot someone in the line of duty every day, and telling them it’s just part of their job. It’s an astonishing lack of compassion.

@Abe has “First Do No Harm.” @MoseyingAlong has a vocation that stretches back as far as humans. I have “Honor, Respect, Devotion to Duty.” I’m not exactly certain what you have, beyond stories that don’t even involve your own suffering.

Thank you for an excellent response. 

I was very young when I decided to be a physician. At that time I knew there would be difficult times, people would die in my presence not being able to safe them etc. I carry my own backpack, full of patients I lost, full of stories that will break your hart. But that's how it is, and I carry that backpack without a single complaint.

But stating we should have been anticipating years of hell and basically saying it's our own fault for not foreseeing.... It just blows my mind...
Title: Re: How long can we wait while flattening the curve?
Post by: Wolfpack Mustachian on April 02, 2020, 07:21:53 AM
Of course people know bad things are coming.

Over the course of a 15 year career, I’ve responded to six hurricanes, and one earthquake. Haiti, Katrina, Maria, Michael, Florence, Dorian. Each response left me with something that will never leave my brain. Haiti above all. The saving grace is that I’ve been able to spread those moments out across 15 years, with gaps in between.

You’re asking medical workers to live disaster response day, after day, after day, for an untold amount of time. To use your analogy: it’s asking a LEO to shoot someone in the line of duty every day, and telling them it’s just part of their job. It’s an astonishing lack of compassion.

@Abe has “First Do No Harm.” @MoseyingAlong has a vocation that stretches back as far as humans. I have “Honor, Respect, Devotion to Duty.” I’m not exactly certain what you have, beyond stories that don’t even involve your own suffering.

Thank you for an excellent response. 

I was very young when I decided to be a physician. At that time I knew there would be difficult times, people would die in my presence not being able to safe them etc. I carry my own backpack, full of patients I lost, full of stories that will break your hart. But that's how it is, and I carry that backpack without a single complaint.

But stating we should have been anticipating years of hell and basically saying it's our own fault for not foreseeing.... It just blows my mind...

Thank you for articulating this. And on top of it all, what's the point of espousing that point of view at all. The people who are saying it aren't hospital workers on the front lines...they aren't dealing with it. They're Monday morning quarterbacks of the worst kind - telling others going through trauma how they should feel about it. We all have our stuff right now, but medical workers are at the top of the pile of crappy stuff. Let's please leave them some love and not comment on how they should have mentally been prepared for this somehow.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on April 02, 2020, 08:46:09 AM
^ agreed.

i'm a senior engineer in my 15 person office. i lead the day to day office management and most engineers report to me. i am worried that i will be outworked by the younger engineers because they're single/young and don't have kids. i normally stick to 40 hour weeks, though for the past half year, am around 60 hour weeks.

the shit will hit the fan soon for our industry and the day of reckoning will come. while under almost all of my previous theorized circumstances i think i would've been safe, this disruption to the economy is something completely different.

You're not alone, this is happening everywhere. My wife's company has told the workforce that they won't be able to keep everyone due to coronavirus. Since that announcement, employees are now literally fighting over themselves trying to take on as much work as possible. The young and single are working 60-80 hours a week in an effort to stand out as "valued" employees as @lutorm would put it. We have a toddler at home and are both tele-working full time so there's no way we can compete. I think the best case scenario is one of us gets fired and gets unemployment so that the other can remain competitive by working 1 and a half jobs or 2 jobs for the same amount of money.

Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on April 02, 2020, 09:55:29 AM
"Translating that to the US, we are looking at maybe 40-50k deaths.  Still terrible but way less than what would be a catastrophic event."
----------------------------------------------------------------------------------------------------

I hope you and the Imperial Study are right, Millionaire

*USA has 1000 total deaths as of today (75 deaths per day at this time), and assuming EVERYONE is 100% serious about social distancing beginning today, we will have about 15 days of additional exponential positive infection tests [the infections themselves have mostly already occurred, they just haven't been diagnosed or counted], with corresponding 15 days of additional exponential deaths. There will be a 6-9 day delay between diagnosis and death for the unlucky. This also assumes we don't overwhelm the medical system. Lots of assumptions here, I know. All these assumptions are conservative.

So infections are at 75K in USA today, will double 5 times before they decrease their rate of growth, and hopefully turn the corner after that. At exponential peak, we will have 2,400,000 infected.

This leads to 75 deaths per day doubling 5 times, or 4650 new deaths by end of April 10th, total of 5650 deaths by Good Friday. Add the 6-9 day delay from diagnosis till death and we will have 20050 deaths total in 3 weeks. Reverse it for an additional 20050 assuming no new infections from then on, and we will have 40100 deaths in 6 weeks.

I am not at all certain about my numbers above, please check my math.

The tighter the control of spread FROM TODAY ON, the closer the results will be to the math. The looser the control of spread, and that number will only be higher.

This is so awful. It turns out my prediction (from just 7 days ago!!!) was woefully optimistic. Today, 8 days from Good Friday, the USA is already at 5150 deaths!
Title: Re: How long can we wait while flattening the curve?
Post by: mm1970 on April 02, 2020, 10:12:05 AM
Why is isolation such a burden for people.

Isolation in a tin roof shanty with no sanitary facilities - okay!

Isolation in a dry, heated/cooled western home with electricity and running water likely with TV and internet? What IS the problem?

We've really enjoyed time at home despite the worries about this virus. Its been a staycation. Games, TV, music, books, good food, and chores. Also - hobbies.

For us it's the compounding problem of being required to work from home while raising a toddler in a confined space with no day care or external support. 
That is crushing, for us.  Our daughter doesn't understand why she can't see her friend across the yard, or play at daycare or use the playground (now encased in 'Police Tape'), her world has been confined to a few rooms and walks around the block.

At the same time we both must work, but with many of the necessary tools (physical and virtual) less available to us.  Wife spends 4-5 hours in virtual meetings each day but document sharing is incredibly problematic... she can't just scan, print and share with everyone.  Lots of the people she's meeting with lack strong internet connections and/or technical saavy.  Every 'meeting' begins with several minutes of group tech-support and inevitably at least one or two people are listening on cellphones, unable to fully participate.  Accessing the secure server isn't an option, so files have to made through special requisitions made to the poor IT guys that are still in the building.... which is a lot like asking someone else to locate an item in your home...

I'm furloughed but still expected/requires to perform many of my duties, particularly to my students.  That's particularly frustrating knowing I have an obligation to do quality work but will not ever be compensated for the time I spend now.

Then there;'s the very heavy emotional toll, which neither of us really expected.  We have elderly parents who we can't see, and who can't see their grandchildren.  Spouse has a frail grandfather who very could pass away before we're allowed to visit.  I have three family members working on the front lines of COVID and I know their exposure risk is sky-high.  And then there's all the other close friends we can't physically be there for; my friend recovering from a divorce, my BIL who's struggling with a colicky infant, etc.  Video chat is good, but it's hard when you know there's no way you can actually be there in person.

In short - we've never had so much on our plate for so little compensation or support.
+2

For us, it's going okay so far.  First, my husband is an introvert. Second, I am a *slight* introvert, but maybe more of one than I thought. This forum, my family, facebook, and texting my friends is working in the meantime.  But I normally get all my need for people at the gym...I don't have that right now.

We are both expected to be working full time (though our employers are pretty understanding), from home, in a 2BR, 1 BA house.  Yesterday, "distance learning" started, so we have 3 makeshift desks and a kitchen table.  Do you think the 7 yo is going to be able to do his school work alone?  No.

Other people who are extroverts have it WAY worse.  And there are a large % of kids at our son's junior high that don't have internet anymore (cannot afford it), don't have an iPad (they left it at school and it's impossible to get through to people to get a replacement).  How are THEY going to do their distance learning?

It's not been a staycation for us.  Even "spring break", which was essentially 2 weeks long - we both had to WORK. Other people are losing their jobs - that's worse, but it doesn't mean that this doesn't suck.
Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on April 02, 2020, 11:38:00 AM
This is so awful. It turns out my prediction (from just 7 days ago!!!) was woefully optimistic. Today, 8 days, from Good Friday, the USA is already at 5150 deaths!

Crisis of leadership means efforts are half-assed at best, and were definitely late. But still this is much better than the "no changes at all" alternative.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 02, 2020, 11:48:50 AM
"Translating that to the US, we are looking at maybe 40-50k deaths.  Still terrible but way less than what would be a catastrophic event."
----------------------------------------------------------------------------------------------------

I hope you and the Imperial Study are right, Millionaire

*USA has 1000 total deaths as of today (75 deaths per day at this time), and assuming EVERYONE is 100% serious about social distancing beginning today, we will have about 15 days of additional exponential positive infection tests [the infections themselves have mostly already occurred, they just haven't been diagnosed or counted], with corresponding 15 days of additional exponential deaths. There will be a 6-9 day delay between diagnosis and death for the unlucky. This also assumes we don't overwhelm the medical system. Lots of assumptions here, I know. All these assumptions are conservative.

So infections are at 75K in USA today, will double 5 times before they decrease their rate of growth, and hopefully turn the corner after that. At exponential peak, we will have 2,400,000 infected.

This leads to 75 deaths per day doubling 5 times, or 4650 new deaths by end of April 10th, total of 5650 deaths by Good Friday. Add the 6-9 day delay from diagnosis till death and we will have 20050 deaths total in 3 weeks. Reverse it for an additional 20050 assuming no new infections from then on, and we will have 40100 deaths in 6 weeks.

I am not at all certain about my numbers above, please check my math.

The tighter the control of spread FROM TODAY ON, the closer the results will be to the math. The looser the control of spread, and that number will only be higher.

This is so awful. It turns out my prediction (from just 7 days ago!!!) was woefully optimistic. Today, 8 days, from Good Friday, the USA is already at 5150 deaths!

Yeah. I don't think the mathematicians on the board understand the dynamics of pandemics. Each infected person infects 2/3 more. Your daily cases are still increasing. Meanwhile, even if the daily cases were static, the death rate would be increasing at an uneen rate because A) it takes people a long time to die ie 4 weeks on a ventilator so many infected a month ago haven't come through the numbers yet and B) the death rate increases as the health care breaks down (lack of resources, staff numbers dropping due to infection, stress and panic). I wouldn't underestimate an increase in the death rate from the influences of stress and poor diet in the near future also. As you get towards a poorer outcome for covid patients in hospitals, some will opt to keep them home so they can die with family. And so even more people will be infected. You're also WAAAAAAY off assuming that everyone will be serious about social distancing. Maybe 80% of people will see the need and do an 80% job of social distancing. The rest will do whatever they like, some of which will be due to ignorance.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 02, 2020, 01:49:25 PM
Of course people know bad things are coming.

Over the course of a 15 year career, I’ve responded to six hurricanes, and one earthquake. Haiti, Katrina, Maria, Michael, Florence, Dorian. Each response left me with something that will never leave my brain. Haiti above all. The saving grace is that I’ve been able to spread those moments out across 15 years, with gaps in between.

You’re asking medical workers to live disaster response day, after day, after day, for an untold amount of time. To use your analogy: it’s asking a LEO to shoot someone in the line of duty every day, and telling them it’s just part of their job. It’s an astonishing lack of compassion.

@Abe has “First Do No Harm.” @MoseyingAlong has a vocation that stretches back as far as humans. I have “Honor, Respect, Devotion to Duty.” I’m not exactly certain what you have, beyond stories that don’t even involve your own suffering.

Thank you for an excellent response. 

I was very young when I decided to be a physician. At that time I knew there would be difficult times, people would die in my presence not being able to safe them etc. I carry my own backpack, full of patients I lost, full of stories that will break your hart. But that's how it is, and I carry that backpack without a single complaint.

But stating we should have been anticipating years of hell and basically saying it's our own fault for not foreseeing.... It just blows my mind...

Thank you for articulating this. And on top of it all, what's the point of espousing that point of view at all. The people who are saying it aren't hospital workers on the front lines...they aren't dealing with it. They're Monday morning quarterbacks of the worst kind - telling others going through trauma how they should feel about it. We all have our stuff right now, but medical workers are at the top of the pile of crappy stuff. Let's please leave them some love and not comment on how they should have mentally been prepared for this somehow.

I appreciate you all backing us up on this. So far, we're doing alright (except my wife lost her job) but my cousins' family is really under stress since they're in NYC. New York Presbyterian is expecting employees to show up even if they are sick with COVID. The whole lack of macro-scale management is just infuriating. No transfer outs of stable patients to make room for unstable patients. No stockpiling of PPE despite 3 month warning. No isolation orders until the number started going up. Honestly none of the current politicians (Trump, Cuomo, De Blasio) should win re-election due to their piss-poor management of this epidemic. That's more infuriating. Going to work is fine. It's the idiots running the show who make me mad. Luckily here in California the management has been much better, people are staying home and we should weather the storm relatively well.
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on April 02, 2020, 03:39:58 PM

The news seems to keep getting worse.  I'm hearing more about young people in their 30's, no underlying health conditions, looking like models of fitness, and dying from COVID-19.
Title: Re: How long can we wait while flattening the curve?
Post by: Northern gal on April 02, 2020, 04:24:27 PM
I think many are mistaking the choice as between flattening the curve  and saving the economy.

I don't see the economy recovering UNTIL people stop being scared of ending up in hospital which will likely be based on reports of the state of their local hospitals' capacity, shortages of PPE, machines, staff etc  and local infection/death rates.


Here is a reasonable thought experiment ( for USA):
Assume that social distancing rules remains spotty with thousands of cars driving between cities and communities every day so the virus eventually spreads to every community in the USA.
In the next 6 weeks,  hospitals across the nation run at or beyond capacity for months after with no elective surgery - even in small towns.

Further assume that we are told by White House  that 'people die, deal with it and go stimulate the economy'.

If Joe Public believes that his local hospital is a death trap and that there is a serious risk of ending up there if he does go out to to the restaurant, will he do so anyway?
Will that worry cause him to not buy that new sofa, car etc and instead save some money just in case?


In normal times, the state of the US economy has always been driven by consumer confidence.
Why should now be any different?

This is pretty much what happened in parts of Australiaand I believe the US West Coast. Way before the government decided to close things, anyone who could self isolated of their own volition.

The problem is you need 90-80 of the population to self isolate for it to stop the spread. So without an officiallockdown you end up with a bad economy and a pandemic.
Title: Re: How long can we wait while flattening the curve?
Post by: Northern gal on April 02, 2020, 04:28:08 PM
Everyone keeps talking about ventilators as some sort of cure all.  I have news for you all...it takes a TEAM of medical professionals to take care of ventilated patients.  Respiratory therapists, nurses, nursing assistants and MDs to oversee the care of these ventilated patients.  The typical ratio for ventilated patients to nurses is 2:1.  Given these are atypical times, 3:1 and possibly even higher ratios could be a possibility I don't doubt.  So if you need 20,000 ventilators, they'd better come with 10,000 trained nurses who know how to care for vented patients. 
Source: ICU RN

It also takes a dialysis machine and ECMO apparatus and teams to handle those.

And remember how the whistleblower Chinese doctor who tried to warn the world died from Covid? He was 34 and healthy.

https://m.youtube.com/watch?v=Bn3nV4viapg
Title: Re: How long can we wait while flattening the curve?
Post by: Cassie on April 02, 2020, 06:20:11 PM
Just read that a 28 year old was advocating on social media for leaving everything open and taking your chances and 3 days later is dead.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on April 02, 2020, 06:47:22 PM
The reason you're hearing about young people dying is because it's very rare.

https://www.worldometers.info/coronavirus/coronavirus-age-sex-demographics/

It's a smidge worse than an average year influenza for your average avocado-toast Millennial.

That doesn't mean those young folks can't infect and kill older folks. But when they blow off the risk to themselves, they're basically correct.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: afox on April 02, 2020, 07:25:46 PM

It's a smidge worse than an average year influenza for your average avocado-toast Millennial.


Are you sure about that? I cant find the number easily but I thought I saw somewhere that COVID was many times more deadly than influenza for all age groups.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on April 02, 2020, 07:32:19 PM

It's a smidge worse than an average year influenza for your average avocado-toast Millennial.


Are you sure about that? I cant find the number easily but I thought I saw somewhere that COVID was many times more deadly than influenza for all age groups.

Read the link. Usual caveats - it's an evolving situation, we don't have great testing, this is just the folks that have interacted with the medical system.

But it's 0.2%. Average influenza is 0.1%. That's definitely worse! But still not a huge risk if you're 22.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on April 02, 2020, 07:40:25 PM
I disagree with your premise @lutorm.
For many, many people, they work for businesses that are currently furloughing and laying off workers as they are forced to close and productivity & revenue has already ground to a crawl.  If someone comes up to management and says “I need greater flexibility” that person is very likely to be on the next list of layoffs.  From a practical standpoint, what many businesses need is survive is to quickly slash their payroll and to retain only the bare minimum which might allow them to putter along until this opens back up in a few months.
Well, sure, but if your business is hibernating you're not likely to have a problem needing to work 60h weeks which was the premise of the comment.

I can only speak from personal experience and my employer has shown unexpected flexibility. But we are "essential business", so we're not shutting down either. It obviously depends on how hard you are to replace, though.
Title: Re: How long can we wait while flattening the curve?
Post by: lutorm on April 02, 2020, 07:48:16 PM

And remember how the whistleblower Chinese doctor who tried to warn the world died from Covid? He was 34 and healthy.
I read an article in the NYT by a molecular biologist pointing out that the viral dose you get when infected likely affects how sick you get (it does with other viral diseases, but there obviously aren't any data for COVID). They speculated that the reason it appears we seem to hear about significant fatalities among young and otherwise healthy medical personnel is that they are likely to receive a very large dose if they don't have proper PPE or weren't wearing any while working on infectious patients. It'll be harder for the body to fight that off compared to if you touch a surface that someone touched yesterday and pick up a minimal dose.

I thought this article was interesting because, as they pointed out, infection is being talked about as an all or nothing kind of thing, but anything we can do to at least lower the amount of viruses that people are likely to pick up (like wearing improvised masks), while it may not prevent people from getting infected, can still mean that the outcome is less severe, so we should adopt an "every little thing helps" sort of principle.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on April 02, 2020, 09:33:20 PM

It's a smidge worse than an average year influenza for your average avocado-toast Millennial.


Are you sure about that? I cant find the number easily but I thought I saw somewhere that COVID was many times more deadly than influenza for all age groups.

Read the link. Usual caveats - it's an evolving situation, we don't have great testing, this is just the folks that have interacted with the medical system.

But it's 0.2%. Average influenza is 0.1%. That's definitely worse! But still not a huge risk if you're 22.

-W

i read the link, it didnt have mortality for influenza.

It looks like you made an honest mistake, it looks like you're comparing the average mortality rate for all ages of influenza to the youngest age groups mortality rate for covid. 

this article compares the mortality rate for the two, the age groups dont align perfectly but generally the mortality rates for covid appear to be 10-25 times higher than they are for influenza for younger people:
https://www.businessinsider.com/coronavirus-compared-seasonal-flu-in-the-us-death-rates-2020-3

you're right that its an evolving situation and we dont have all the data yet but every indication is that covid is much much more deadly than influenza for all age groups.
Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate on April 02, 2020, 09:52:35 PM
But it's 0.2%. Average influenza is 0.1%. That's definitely worse! But still not a huge risk if you're 22. -W


The CDC has information on these sort of things, for the 18-49 year year old bracket here's the past fatality rate for the flu:

2017-2018 =0.019%
2016-2017 =0.014%
2015-2016 =0.018%
2014-2015 =0.011%
2013-2014 =0.026%
2012-2013 =0.018%
2011-2012 =0.021%
2010-2011 =0.070%

So, a 0.2% rate for that group would be about 3x a bad flu year, and 10x a good flu year.

https://www.cdc.gov/flu/about/burden/2017-2018.htm (https://www.cdc.gov/flu/about/burden/2017-2018.htm)
Divided Deaths by Symptomatic Illnesses for these numbers.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on April 02, 2020, 10:20:16 PM
Those are estimated illnesses, YttriumNitrate. That's not really comparable, as the C19 numbers are only including patients who are sick enough to seek out medical services mostly (though in a few places there's enough testing that there are more people in the pool than just sick folks).

That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason.

Again, this is not trying in any way to minimize the problem - but if you're young, you do not need to worry too much about your own death from C19. Hearing about someone young dying on the news is a good sign (for you, if you're young) - it's rare and hence newsworthy.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: frugalnacho on April 02, 2020, 10:24:26 PM
In addition to being deadlier for every age group, shouldn't it be weighted by your likelihood to actually contract the virus?  Coronavirus is highly contagious and everyone is susceptible.

I'd much rather get  infected with the coronavirus than Ebola because it's far less deadly, but the odds of me being exposed to coronavirus are so much greater than Ebola that coronavirus is a far greater threat to me.

Coronavirus is not only more deadly than influenza, but you're probably more likely to catch it than influenza.  I know there are a lot of flu infections out there too, so I don't know this to be absolutely true, but it seems likely to me. at least that's how I'm perceiving the threat.
Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on April 02, 2020, 10:25:40 PM
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


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Title: Re: How long can we wait while flattening the curve?
Post by: BostonBrit on April 02, 2020, 10:27:50 PM
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


Sent from my iPhone using Tapatalk

So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.
Title: Re: How long can we wait while flattening the curve?
Post by: Travis on April 03, 2020, 01:09:11 AM
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


Sent from my iPhone using Tapatalk

So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.

In the last month I've seen a number of posts that look like "X thousands die from the flu each year. This is no big deal." If the flu infection/death numbers are true and for the moment comparable to COVID-19 numbers, why do we not hear of ERs and ICUs being crushed with flu cases each year?
Title: Re: How long can we wait while flattening the curve?
Post by: MoseyingAlong on April 03, 2020, 01:26:41 AM
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


Sent from my iPhone using Tapatalk

So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.

In the last month I've seen a number of posts that look like "X thousands die from the flu each year. This is no big deal." If the flu infection/death numbers are true and for the moment comparable to COVID-19 numbers, why do we not hear of ERs and ICUs being crushed with flu cases each year?

Because the flu is business as usual and we plan for (try to staff for) the annual fullhouse. Some years it's worse than anticipated and the ED overflows.
COVID19 is worse, more contagious and deadly, but a whole lot of people don't realize how bad the flu is most years because we're just used to it.
Title: Re: How long can we wait while flattening the curve?
Post by: MoseyingAlong on April 03, 2020, 01:36:25 AM

In the last month I've seen a number of posts that look like "X thousands die from the flu each year. This is no big deal." If the flu infection/death numbers are true and for the moment comparable to COVID-19 numbers, why do we not hear of ERs and ICUs being crushed with flu cases each year?

Because the flu is business as usual and we plan for (try to staff for) the annual fullhouse. Some years it's worse than anticipated and the ED overflows.
COVID19 is worse, more contagious and deadly, but a whole lot of people don't realize how bad the flu is most years because we're just used to it.

Adding. The CDC reports that there have been 155 pediatric deaths from the flu this season. How many of them have been front page news?
The flu is a serious problem that we don't treat that way.
Title: Re: How long can we wait while flattening the curve?
Post by: Kyle Schuant on April 03, 2020, 03:04:59 AM
Far fewer people with the flu require ventilators. There's just a higher level of care - more equipment, more staff, etc - with this thing. As well remember that this is coming as well as the flu, not instead of it. It's like saying, "why are you worried about a big natural gas bill? You get big electricity bills all the time."
Title: Re: How long can we wait while flattening the curve?
Post by: former player on April 03, 2020, 03:15:01 AM
Being as I am a tad older than the 18 - 44 age group, my death rate is also higher.  What I am looking at is not my chance of dying of covid-19 as against the flu (and I remember having the flu as an adult, it was nasty and for one night in particular rather worrying) but my relative chance of dying of covid-19 as against anything else.  Given that I have had a reassuringly healthy report on my cardiovascular system, there is little to no cancer or dementia in my family background and my driving is unadventurously slow and local, covid-19 is probably my biggest risk of death in a very long time.  Fortunately I'm FIREd and my social distancing/social isolation is no real loss to the economy.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 03, 2020, 03:45:15 AM
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


Sent from my iPhone using Tapatalk

So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.

In the last month I've seen a number of posts that look like "X thousands die from the flu each year. This is no big deal." If the flu infection/death numbers are true and for the moment comparable to COVID-19 numbers, why do we not hear of ERs and ICUs being crushed with flu cases each year?

The flu is a known seasonal factor that is planned for. Staff are vaccinated against it, and treatment options are well explored.

Corona virus is crashing the system because
- we were not expecting it and were not prepared with existing resources
- staff are not immune to it and have to be stood down after each exposure, sometimes dozens at a time
- we don't know how to treat it, so we're only treating the results, which is why people end up on ventilators at much higher rates than the flu
- people are taking a long time to die from corona virus compared to the flu, so taking up resources for longer
- corona is far more infectious than the flu, so the cases are increasing, not dropping off
- the death rate of corona is far higher than the flu, completely apart from the fact that many are dying because of the crashed health system
- the response to corona has been poor, in part because of the factors above but also because of political considerations. The flu response is rarely impeded by political factors. We don't see every year a president whining about the amount of PPE that has been requested for flu. No politician is trying to cover their arse in an election year because of flu.
Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate on April 03, 2020, 06:50:55 AM
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.
Title: Re: How long can we wait while flattening the curve?
Post by: Davnasty on April 03, 2020, 07:28:11 AM
But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


Sent from my iPhone using Tapatalk

Typically when you read stats on the flu they're adjusted to estimate total cases, not just confirmed cases.

I haven't fact-checked anyone's data in this thread, but this is probably a safe assumption.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on April 03, 2020, 08:21:30 AM
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.

Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: OurTown on April 03, 2020, 08:25:30 AM
Good analysis here:  https://www.politico.com/news/magazine/2020/04/02/coronavirus-economy-reopen-deaths-balance-analysis-159248
Title: Re: How long can we wait while flattening the curve?
Post by: cerat0n1a on April 03, 2020, 08:35:24 AM
Spanish flu disproportionately affected the young and those with the strongest immune systems. The highest mortality rates were for the 15-34 age range. In 1918-19, 99% of those who died of it in the US were under 65. A really "bad" flu year can therefore be very much worse than Covid-19 for people in this age range.

Of course, there were some special factors in play. Normally in a pandemic, natural selection favors replication of forms of the virus which don't kill their host - dead or severely ill people don't spread the virus as well as living people. In a wartime situation, the opposite was true.
Title: Re: How long can we wait while flattening the curve?
Post by: afox on April 03, 2020, 09:06:21 AM
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.

Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

Im not sure how the death rates for covid were estimated but keep in mind that other countries haven't had the testing limitations that the US has.
Both for flu and covid only people with severe symptoms present at a doctors office for testing.

I dont understand what your argument is @waltworks? Are you saying that the data is wrong and covid is "just a smidge" more deadly than the flu for younger people?
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on April 03, 2020, 09:12:29 AM
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.

Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

Isn't that also true of any flu numbers we have though?  Most people with the flu just stay home and get better.  No need to go to a doctor.

I think the 3 - 10x increased risk with covid-19 is probably pretty accurate.
Title: Re: How long can we wait while flattening the curve?
Post by: waltworks on April 03, 2020, 09:23:07 AM
Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

Isn't that also true of any flu numbers we have though?  Most people with the flu just stay home and get better.  No need to go to a doctor.

I think the 3 - 10x increased risk with covid-19 is probably pretty accurate.

No, the number Nate is quoting is *estimated* flu cases. The CDC does this every year as the flu is pretty well understood, so a reasonable estimate can be made of the people who had it but didn't seek medical care. Most years they estimate there are 2-2.5 times as many symptomatic illnesses total as medical visits for influenza.

C19 is not well enough understood yet to generate an estimate of mild/asymptomatic cases, so the mortality rates are based on confirmed (tested) cases. There could be 10 times as many cases, there could be 100 times. We don't have enough testing for even symptomatic people, let alone enough testing to get a picture of how many mild/no symptom cases there have been.

-W
Title: Re: How long can we wait while flattening the curve?
Post by: frugalnacho on April 03, 2020, 09:23:57 AM
I've never had a flu test performed, although I'm pretty sure I've had the flu a few times in my life.  I've also never gone to the hospital for the flu, or died from it.
Title: Re: How long can we wait while flattening the curve?
Post by: Hirondelle on April 03, 2020, 09:25:08 AM
That said, the burden (an estimated 41,000,000 illnesses and 60,000 deaths) is .13%. You moved the decimal place on your numbers for some reason. -W

Walt, 41 million flu illnesses everyone, the numbers I quoted are "for the 18-49 year year old bracket" since your previous comments specified 22 year olds. In 2017-2018, there were an estimated 14,428,065 flu illnesses in that demographic, with ~2,803 deaths. That's an estimated 0.019% mortality rate for 18-49 year olds.

Ah, got it. But again, that's estimated cases. We don't have a useful estimate for C19 yet, but I'd bet there are 10x as many cases out there among younger folks that have not been tested or come in contact with the medical system.

-W

Im not sure how the death rates for covid were estimated but keep in mind that other countries haven't had the testing limitations that the US has.
Both for flu and covid only people with severe symptoms present at a doctors office for testing.

I dont understand what your argument is @waltworks? Are you saying that the data is wrong and covid is "just a smidge" more deadly than the flu for younger people?

Except Korea and maybe Germany, most countries did/do have testing limitations.
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on April 03, 2020, 09:32:13 AM
I've never had a flu test performed, although I'm pretty sure I've had the flu a few times in my life.  I've also never gone to the hospital for the flu, or died from it.

Same for me.  And I suspect a huge number of other people.  Which makes me really question how they're estimating the flu numbers.
Title: Re: How long can we wait while flattening the curve?
Post by: Slee_stack on April 03, 2020, 09:35:02 AM
Numbers affecting mortality rate debate:

  Actual Flu death numbers
  Actual Flu confirmed cases
  Unconfirmed Flu cases (minor,r or asymptomatic, not tested).
  Rate of Flu spread (contagiousness)
  The above (4) for COVID

COVID is accepted as being  far more contagious than Flu.
Its logical to presume far more people will contact COVID than Flu (in a given time frame). 
Its also logical to presume Unconfirmed COVID cases are higher than Unconfirmed Flu cases.

These 2 factors will ultimately determine how much more deadly COVID is than Flu...in terms of Mortality Rate.

In terms of gross numbers, there will be no debate this year.

We won't likely really know the real rates for another year or so.


If we are all guessing, I'll go with 2-3X overall higher mortality rate than Flu.  For young, healthy folks, I'll guess 1.5 or less. 

Title: Re: How long can we wait while flattening the curve?
Post by: Slee_stack on April 03, 2020, 09:42:13 AM
On another note, USAToday reports this poll about most americans' opinion on flattening the curve:

https://www.usatoday.com/in-depth/news/nation/2020/04/03/coronavirus-poll-americans-saving-lives-economy-public-agenda/5098766002/

Its USAToday, so take it with a grain of salt.  Interesting nonetheless.
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on April 03, 2020, 09:45:45 AM
Numbers affecting mortality rate debate:

  Actual Flu death numbers
  Actual Flu confirmed cases
  Unconfirmed Flu cases (minor,r or asymptomatic, not tested).
  Rate of Flu spread (contagiousness)
  The above (4) for COVID

COVID is accepted as being  far more contagious than Flu.
Its logical to presume far more people will contact COVID than Flu (in a given time frame). 
Its also logical to presume Unconfirmed COVID cases are higher than Unconfirmed Flu cases.

These 2 factors will ultimately determine how much more deadly COVID is than Flu...in terms of Mortality Rate.

In terms of gross numbers, there will be no debate this year.

We won't likely really know the real rates for another year or so.


If we are all guessing, I'll go with 2-3X overall higher mortality rate than Flu.  For young, healthy folks, I'll guess 1.5 or less. 



Yeah, but all of this is just discussing death rate.

How many people have permanent lung damage after recovering from the flu?  Zero?  My guess is that these numbers will also differ for the coronavirus.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 03, 2020, 09:46:27 AM
I've never had a flu test performed, although I'm pretty sure I've had the flu a few times in my life.  I've also never gone to the hospital for the flu, or died from it.

Same for me.  And I suspect a huge number of other people.  Which makes me really question how they're estimating the flu numbers.
The same way you estimate any value within a large population, by treating a representative sub-sample. The CDC routinely tears for antibodies for various pathogens to account for unreported spread

One of the reasons why there is a large uncertainty among total infection rates of covid is those types of data won’t be available until much later, when we can account for such cases.
Title: Re: How long can we wait while flattening the curve?
Post by: Davnasty on April 03, 2020, 09:46:50 AM
I've never had a flu test performed, although I'm pretty sure I've had the flu a few times in my life.  I've also never gone to the hospital for the flu, or died from it.

Same for me.  And I suspect a huge number of other people.  Which makes me really question how they're estimating the flu numbers.

https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm#References

example of study used to create CDC estimates:

https://onlinelibrary.wiley.com/doi/full/10.1111/irv.12486

Quote
Methods
We used routinely collected surveillance data, outbreak field investigations, and proportions of people seeking health care from survey results to estimate the number of illnesses, medical visits, hospitalizations, and deaths due to influenza during six influenza seasons (2010‐2011 through 2015‐2016).

Results
We estimate that the number of influenza‐related illnesses that have occurred during influenza season has ranged from 9.2 million to 35.6 million, including 140 000 to 710 000 influenza‐related hospitalizations.

And still, estimates are generally given as a very wide range. I would imagine the mortality rates are based on some sort of average within these wide ranges.

Correction: actually I think the range I bolded above is based on low-high annual estimates, as in 9.2m was the best year and 35.6 as the worst. However the 95% uncertainty interval can be a pretty wide range as well.

https://www.cdc.gov/flu/about/burden/index.html
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on April 03, 2020, 09:58:04 AM
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS

Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 03, 2020, 10:17:02 AM
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.
Title: Re: How long can we wait while flattening the curve?
Post by: 24andfrugal on April 03, 2020, 10:53:50 AM
At this point it should be crystal clear that there are far more cases than the official numbers indicate, both from the milder cases that are told not to go to the hospital and from the completely or near-completely asymptomatic people who are unaware they have it. While this implies a much wider spread, it also implies that the % of people severely impacted by this is also much lower than is popularly thought.

That said - one of the main reasons this is dangerous, as I understand it, is that it moves much more quickly than the flu. 61k people died and 810k were hospitalized with the flu in 2017, which was considered a "bad year", over the course of maybe 5 months. The projections are that we will see that many deaths in the next 4-5 *weeks*. It's like rain...40 inches of rain in a year isn't that big a deal, but 40 inches of rain in a week is catastrophic.
Title: Re: How long can we wait while flattening the curve?
Post by: runbikerun on April 03, 2020, 10:54:32 AM
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

I think that was part of the point being made - that even in a situation where it's a novel virus and huge chunks of society are shut down to prevent its spread, Covid-19 is already the third largest cause of death on a daily basis in the US and will probably become number one quite soon.
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on April 03, 2020, 11:13:06 AM
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

I think that was part of the point being made - that even in a situation where it's a novel virus and huge chunks of society are shut down to prevent its spread, Covid-19 is already the third largest cause of death on a daily basis in the US and will probably become number one quite soon.

Yup RunBikeRun, the point is to answer question, "how dangerous is Covid19 right now?". Or, "How dangerous is Covid right now as compared to Influenza?" If Nereo doesn't get it, then he must be asking a different question.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 03, 2020, 12:08:35 PM
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

I think that was part of the point being made - that even in a situation where it's a novel virus and huge chunks of society are shut down to prevent its spread, Covid-19 is already the third largest cause of death on a daily basis in the US and will probably become number one quite soon.

Yup RunBikeRun, the point is to answer question, "how dangerous is Covid19 right now?". Or, "How dangerous is Covid right now as compared to Influenza?" If Nereo doesn't get it, then he must be asking a different question.

Here’s the point I’m trying to make - if we do nothing substantial about heart disease or cancer (the #1 & 2 sources of mortality currently) those will not increase by a factor of 10  by the end of the month. That’s why I’m saying comparisons between those can muddy the waters.

Perhaps we are addressing slightly different questions. But I see a lot of people make the comparison between Covid and heart disease and ask “ why are we more concerned about this disease than heart attacks?”  That’s what I’m addressing.
Title: Re: How long can we wait while flattening the curve?
Post by: mancityfan on April 03, 2020, 12:35:14 PM
This is why the US may just get hit the worst. This guy is an example of all that is wrong with the attitudes of enough people, as he rails against his liberties being taken to protect everyone else:

https://www.youtube.com/watch?v=W70G5MPQf7U&t=2s
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 03, 2020, 01:17:02 PM
This is why the US may just get hit the worst. This guy is an example of all that is wrong with the attitudes of enough people, as he rails against his liberties being taken to protect everyone else:

https://www.youtube.com/watch?v=W70G5MPQf7U&t=2s

His opinions about the virus are wacky, but I agree that it's shameful to arrest people trying to exercise and get outside. As long as you are not in a big group (I'd say more than 3-4) and you are practicing social distancing, you're fine.

Our governor (Ohio) has encouraged exercise and I've obliged (I've lost four pounds despite drinking wine seemingly every night!).
Title: Re: How long can we wait while flattening the curve?
Post by: Gin1984 on April 03, 2020, 01:18:38 PM
In addition to being deadlier for every age group, shouldn't it be weighted by your likelihood to actually contract the virus?  Coronavirus is highly contagious and everyone is susceptible.

I'd much rather get  infected with the coronavirus than Ebola because it's far less deadly, but the odds of me being exposed to coronavirus are so much greater than Ebola that coronavirus is a far greater threat to me.

Coronavirus is not only more deadly than influenza, but you're probably more likely to catch it than influenza.  I know there are a lot of flu infections out there too, so I don't know this to be absolutely true, but it seems likely to me. at least that's how I'm perceiving the threat.
Ebola is actually pretty easy to treat in most first world countries. We have no treatment for this.
Title: Re: How long can we wait while flattening the curve?
Post by: bacchi on April 03, 2020, 01:19:49 PM
This is why the US may just get hit the worst. This guy is an example of all that is wrong with the attitudes of enough people, as he rails against his liberties being taken to protect everyone else:

https://www.youtube.com/watch?v=W70G5MPQf7U&t=2s

That guy is fringe. He was railing against Fauci earlier this week.

Title: Re: How long can we wait while flattening the curve?
Post by: frugalnacho on April 03, 2020, 01:45:26 PM
In addition to being deadlier for every age group, shouldn't it be weighted by your likelihood to actually contract the virus?  Coronavirus is highly contagious and everyone is susceptible.

I'd much rather get  infected with the coronavirus than Ebola because it's far less deadly, but the odds of me being exposed to coronavirus are so much greater than Ebola that coronavirus is a far greater threat to me.

Coronavirus is not only more deadly than influenza, but you're probably more likely to catch it than influenza.  I know there are a lot of flu infections out there too, so I don't know this to be absolutely true, but it seems likely to me. at least that's how I'm perceiving the threat.
Ebola is actually pretty easy to treat in most first world countries. We have no treatment for this.

The mortality rate for ebola is still far higher than covid-19, even with the best medical care.  I would still much rather have covid-19 than ebola. 

That's kind of beside my point anyway, which is that comparing the mortality rate of one virus directly against another in isolation doesn't accurately portray the real risk.
Title: Re: How long can we wait while flattening the curve?
Post by: GardenerB on April 03, 2020, 02:50:25 PM
Two recent BBC articles I found had some good explanation on numbers.  Actual fatality rate of course can only be estimated after the fact.  'Case fatality rate' can be shown and updated daily, but it is not the same comparison for yearly flu deaths (for example) as the true 'infection fatality rate'.

UK figures but still relevant for comparison.  Another misleading fact is people keep looking at age alone as a lower risk of death.  But, if someone is obese and young, they essentially fall into a much older age category equivalent versus someone the same age and healthy. 

https://www.bbc.com/news/health-51979654

https://www.bbc.com/future/article/20200401-coronavirus-why-death-and-mortality-rates-differ

'There are, in fact, two kinds of fatality rate. The first is the proportion of people who die who have tested positive for the disease. This is called the “case fatality rate”. The second kind is the proportion of people who die after having the infection overall; as many of these will never be picked up, this figure has to be an estimate. This is the “infection fatality rate”.
In other words, the case fatality rate describes how many people doctors can be sure are killed by the infection, versus how many people the virus kills overall, says Carl Heneghan, an epidemiologist and director of the Centre for Evidence-Based Medicine at the University of Oxford; he is also a GP in recovery from a suspected Covid-19 infection.
To see what a difference this makes, consider 100 people who have been infected with Covid-19. Ten of them have it so severely that they go into hospital, where they test positive for Covid-19. The other 90 are not tested at all. One of the hospital patients then dies from the virus. The other 99 people survive.
That would give a case fatality rate of one in 10, or 10%. But the infection fatality rate would be just one in 100, or 1%.'
Title: Re: How long can we wait while flattening the curve?
Post by: KBecks on April 05, 2020, 05:30:01 AM
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.




Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on April 05, 2020, 07:06:27 AM
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

The question here is how long we're locked down?  In Virginia, which I think is being unusually straightforward regarding the expected duration, the lockdown is until June 10th. I think that's at and perhaps beyond the outer limits of what will be tolerated. At some point, many people just aren't going to obey the stay at home orders.  And conversely other folks are going to have to be coaxed from their homes months from now. The Chinese are noting problems with agoraphobia after their lockdown. 
Title: Re: How long can we wait while flattening the curve?
Post by: Gin1984 on April 05, 2020, 07:10:16 AM
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

The question here is how long we're locked down?  In Virginia, which I think is being unusually straightforward regarding the expected duration, the lockdown is until June 10th. I think that's at and perhaps beyond the outer limits of what will be tolerated. At some point, many people just aren't going to obey the stay at home orders.  And conversely other folks are going to have to be coaxed from their homes months from now. The Chinese are noting problems with agoraphobia after their lockdown.
Well, the amount of time is dependent on how stupid people are....
Title: Re: How long can we wait while flattening the curve?
Post by: KBecks on April 05, 2020, 07:39:30 AM
Kennon's main point is that we are going to have to accept that some deaths are going to happen, just as we would expect war casualties.  People who are vulnerable should self-isolate, sick people should stay home and quarantine, and sooner than later, everyone else needs to get back to work (of course, taking precautions). 

Hopefully, we are flattening the curve.  And a re-opening should probably be gradual and very well thought out about what can open up and what should be limited (maybe interstate and international travel for a longer time?)

People are going to get crushed financially, and Kennon argues that there will be extreme effects and poverty for *generations*. He believes we will cause our own unrecoverable economic collapse if we are shut down too long, and the countdown is on.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on April 05, 2020, 07:46:34 AM
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

The question here is how long we're locked down?  In Virginia, which I think is being unusually straightforward regarding the expected duration, the lockdown is until June 10th. I think that's at and perhaps beyond the outer limits of what will be tolerated. At some point, many people just aren't going to obey the stay at home orders.  And conversely other folks are going to have to be coaxed from their homes months from now. The Chinese are noting problems with agoraphobia after their lockdown.
Well, the amount of time is dependent on how stupid people are....
If stupidity was the standard, then Virginia would need to stay on lock down until, oh, July of 2036. 
Title: Re: How long can we wait while flattening the curve?
Post by: sehr on April 05, 2020, 07:51:27 AM
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

The question here is how long we're locked down?  In Virginia, which I think is being unusually straightforward regarding the expected duration, the lockdown is until June 10th. I think that's at and perhaps beyond the outer limits of what will be tolerated. At some point, many people just aren't going to obey the stay at home orders.  And conversely other folks are going to have to be coaxed from their homes months from now. The Chinese are noting problems with agoraphobia after their lockdown.
Well, the amount of time is dependent on how stupid people are....

In other words, forever?
Title: Re: How long can we wait while flattening the curve?
Post by: NaN on April 05, 2020, 08:11:27 AM
Right, I wish the sky is falling crowd would read this article from a respected Stanford University Epidemiologist and researcher.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

The "respected" Stanford research you quote said: "10,000 deaths ... is buried within the noise of the estimate of deaths from “influenza-like illness.”"

@Viking Thor : Just curious to see how your thoughts have evolved. Have you changed your mind yet? We will likely reach 10k deaths by today or tomorrow. Further, we haven't even realized what that peak "death rate" will be. Look at Italy's statistics - they finally leveled off at about 750 deaths/per day and have been at the "flattened" level for two weeks. Even if we are at our peak today, we easily reach 30k deaths in two weeks, with many weeks of decreasing numbers. That is 50k additional deaths on top of the ballpark numbers on the flu every year. That is assuming we reached our peak. Even skeptic in chief seems to be convinced 100k deaths would be a great outcome now.

Title: Re: How long can we wait while flattening the curve?
Post by: KBecks on April 05, 2020, 08:41:58 AM
Interesting article from Medium that questions when coronavirus first started spreading in the US, titled, The Curve is Already Flat:

https://medium.com/morozko-method/the-curve-is-already-flat-2de80eed1bd0
Title: Re: How long can we wait while flattening the curve?
Post by: ItsALongStory on April 05, 2020, 08:44:30 AM
Right, I wish the sky is falling crowd would read this article from a respected Stanford University Epidemiologist and researcher.

https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-as-the-coronavirus-pandemic-takes-hold-we-are-making-decisions-without-reliable-data/

The "respected" Stanford research you quote said: "10,000 deaths ... is buried within the noise of the estimate of deaths from “influenza-like illness.”"

@Viking Thor : Just curious to see how your thoughts have evolved. Have you changed your mind yet? We will likely reach 10k deaths by today or tomorrow. Further, we haven't even realized what that peak "death rate" will be. Look at Italy's statistics - they finally leveled off at about 750 deaths/per day and have been at the "flattened" level for two weeks. Even if we are at our peak today, we easily reach 30k deaths in two weeks, with many weeks of decreasing numbers. That is 50k additional deaths on top of the ballpark numbers on the flu every year. That is assuming we reached our peak. Even skeptic in chief seems to be convinced 100k deaths would be a great outcome now.

All researchers were clearly using flawed data, either purposely misrepresented or not by China primarily. Testing has been the big caveat all along even in more 'trustworthy' nations like Italy or Spain. This will make anyone involved in this kind of stuff a lot more hesitant to make projections in the future.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on April 05, 2020, 09:35:57 AM
In addition to being deadlier for every age group, shouldn't it be weighted by your likelihood to actually contract the virus?  Coronavirus is highly contagious and everyone is susceptible.

I'd much rather get  infected with the coronavirus than Ebola because it's far less deadly, but the odds of me being exposed to coronavirus are so much greater than Ebola that coronavirus is a far greater threat to me.

Coronavirus is not only more deadly than influenza, but you're probably more likely to catch it than influenza. I know there are a lot of flu infections out there too, so I don't know this to be absolutely true, but it seems likely to me. at least that's how I'm perceiving the threat.

I think this is only true because we have a flu vaccine that a large proportion of the population gets each year and we don't have any anti-bodies for this particular coronavirus. Is there evidence that this is in fact more contagious though? I always kind of figured viral shedding was viral shedding. I guess the fact that many people are asymptomatic or that the symptoms are delayed while the virus is replicating could make it more contagious, but I don't know this for a fact.

But how many people get the flu and never get tested or report it? You cannot take the numbers from flu or anything else as the true number of people that have it as many just as with Covid do not report or seek medical treatment.


Sent from my iPhone using Tapatalk

So 20,000 people a year die from the flu... and 5,000 people have died from this in the last week... with rates expected to double every 3 days.

So same-same.

The # I saw for the flu so far this year in the US was 46k.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on April 05, 2020, 09:44:18 AM
Let's simplify the discussion:

Top 5 deaths per day (right now) in the USA -> using CDC data

1.Heart Disease -1774 deaths per day
2.Cancer -          1641 deaths per day
3.Covid19           900 deaths per day
4.Accidents         465 deaths per day
5.Chronic Pulm    438 deaths per day (chronic lower respiratory diseases)
***Influenza 2018 93 deaths per day

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm

Covid19 deaths will only increase day to day over the next 30 days.

JGS
That’s not simplifying, that is confounding. Those others are essentially constant, and there are largely the result of chronic conditions. Comparing those to a contagion is apples to butterflies.

I think that was part of the point being made - that even in a situation where it's a novel virus and huge chunks of society are shut down to prevent its spread, Covid-19 is already the third largest cause of death on a daily basis in the US and will probably become number one quite soon.

This is taking the peak and using that #. There have been ~ 95 days in the year so far and 8,516 deaths. That doesn't seem to equal 900 deaths per day. Given this is an average of deaths per day it would imply roughly 330k deaths from the virus this year. Time will tell, but that seems far higher than any projections I've seen.
Title: Re: How long can we wait while flattening the curve?
Post by: Davnasty on April 05, 2020, 10:43:22 AM
Joshua Kennon wrote an interesting blog piece about the virus vs. the economy. He suggests that we may face an unrecoverable economic depression if the shutdown lasts too long. Also, check the comments in both articles. 

https://www.joshuakennon.com/what-price-should-we-pay-to-fight-covid-19/

https://www.joshuakennon.com/u-s-covid-19-projections-slashed-to-100000-to-200000-deaths/

After reading both, I am scared.  I am optimistic for the possible drug combination and better testing and for a vaccine.  But  I hope that this is not the beginning of economic collapse.

His primary contention is not wrong, life has a dollar value and we need to weigh the costs of our decisions, not simply yield to our emotions. But the intense fear-mongering paired with a lack of data and citations for his claims was too much for me, I'll admit I couldn't get through the whole post.

Quote
Desperate to flatten the curve in their local communities, and without properly weighing the net trade-offs involved, they began enforcing lock-downs on society, closing businesses against their will and forbidding people to congregate in even mid-size groups.

I see this claim made quite a bit, but nothing to back it up. How does he know they haven't properly weighed the trade-offs? He presents the decisions we've made as if they've only been advised by healthcare researchers but that is not true. You can be sure that the economists advising the governments of the world are voicing their opinions right now.

Quote
My guess: We have approximately twelve to sixteen weeks of shut-down before a Great Depression can be avoided.  That is by necessity an imprecise figure but it’s the closest I can get. Accordingly, I refuse to support an indefinite shut-down longer than that period because I feel to do so would be immoral.

Again, how did he arrive at this guess? he offers no data on economic impacts we've seen so far, no timelines to indicate a point of no return, he gives nothing more than a list of ways we will be impacted with a complete lack of data. This would be fine if he meant it to be a conversation starter, but he actually uses these one-off thoughts to draw conclusions as to what should be done. Preposterous.

Then he refers to our current situation as the "shut-down" without acknowledging that there are differing degrees of shut-downs. Most likely restrictions will be lifted in phases based on research that was done prior to the pandemic and is being done right now. The author flippantly disregards the massive efforts in research to advise the governments of the world.

My greatest concern is that governments choose to bend to the fear and emotions of their citizens rather than listen to the experts but unlike the author I acknowledge that that could go in either direction. Some overweight the fear of death and others overweight the fear of economic impacts while forgetting that we'll see much of that economic impact regardless of whether we "shut-down" the economy or not.

tl;dr I think the author's reactions are driven by fear and emotions in the same way as those he seeks to criticize. Of course human lives don't have infinite value. Of course the shut-down can't go on forever. So where's the data to support his rationally superior assessment?

ETA: Here's a more thorough look at the pros & cons of economic restrictions with data and research to back it up. I can't say I agree with all of it as I've only skimmed so far.

https://www.politico.com/news/magazine/2020/04/02/coronavirus-economy-reopen-deaths-balance-analysis-159248#4
Title: Re: How long can we wait while flattening the curve?
Post by: rob in cal on April 05, 2020, 02:47:24 PM
  I'm intrigued, and somewhat optimistic, about whats happening with deaths in several of the US states where death numbers per day are stagnating and not growing exponentially, not showing NYC area skyrocketing. Now perhaps its underreporting, a further lag time before takeoff, who knows, but states like Georgia, Illinois, Connecticut, Massachusets, California, even Michigan, (which hit 80 deaths a few days ago, but hasn't moved much since then) while they might be showing some growth in daily death rate, and certainly are reporting significant new cases every day, so far they seem to be avoiding anything like NYC area death number dynamics.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 05, 2020, 04:11:39 PM
I’ve been tracking the Johns Hopkins data on a state basis for a month, and so far California and Washington has been relatively flat with deaths per day. I don’t think cases is a useful metric for various reasons explained before due to lack of testing capability. But deaths are deaths, and so far every outbreak the deaths have tracked 1-2 weeks behind cases being reported.

The troubling thing is that Italy’s had about 2 weeks of stable death rates since they peaked. It looks more like a mesa rather than a “peak”. NY has tracked almost exactly with Italy in terms of deaths per day, so I expect a similar curve. Too early to say about other sites with sharp upticks, but death curves have definitely been Lower everywhere other than NY/NJ. Fingers crossed it’s limited to there, then all the economists can bitch and moan about us “over-reacting”. Better to have that argument than the “what do we do with all the rotting corpses” argument.
Title: Re: How long can we wait while flattening the curve?
Post by: runbikerun on April 06, 2020, 02:17:37 PM
This is taking the peak and using that #. There have been ~ 95 days in the year so far and 8,516 deaths. That doesn't seem to equal 900 deaths per day. Given this is an average of deaths per day it would imply roughly 330k deaths from the virus this year. Time will tell, but that seems far higher than any projections I've seen.

It really shouldn't be necessary to explain why it makes absolutely no sense to take an average figure for each of the 95 days of the year so far.

Confirmed Covid-19 deaths yesterday: 1,175
Confirmed Covid-19 deaths the day before: 1,352
Confirmed Covid-19 deaths the day before that: 1,186
Confirmed Covid-19 deaths the day before that: 1,075
Confirmed Covid-19 deaths the day before that: 940

Right now, Covid-19 is demonstrably the second or third most effective killer of Americans on a daily basis and has been for almost a week. Terrifyingly, those numbers almost certainly don't fully reflect the death toll; a huge number of people are going to die without a positive diagnosis. And yet, even without those deaths being counted, it's killing more Americans each day than almost anything else. It's producing a 9/11 in verified death toll almost three times a week.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on April 06, 2020, 04:53:39 PM
This is taking the peak and using that #. There have been ~ 95 days in the year so far and 8,516 deaths. That doesn't seem to equal 900 deaths per day. Given this is an average of deaths per day it would imply roughly 330k deaths from the virus this year. Time will tell, but that seems far higher than any projections I've seen.

It really shouldn't be necessary to explain why it makes absolutely no sense to take an average figure for each of the 95 days of the year so far.

Confirmed Covid-19 deaths yesterday: 1,175
Confirmed Covid-19 deaths the day before: 1,352
Confirmed Covid-19 deaths the day before that: 1,186
Confirmed Covid-19 deaths the day before that: 1,075
Confirmed Covid-19 deaths the day before that: 940

Right now, Covid-19 is demonstrably the second or third most effective killer of Americans on a daily basis and has been for almost a week. Terrifyingly, those numbers almost certainly don't fully reflect the death toll; a huge number of people are going to die without a positive diagnosis. And yet, even without those deaths being counted, it's killing more Americans each day than almost anything else. It's producing a 9/11 in verified death toll almost three times a week.

But you are comparing yearly averages to something that clearly won't be killing 1100/day for an entire year. Why not compare it to peak death tolls for everything else too? I'm certain that there are days where death tolls for accidents are substantially higher than 465...but if you average it out for the entire year it averages to be 465 deaths per day. It's comparing apples to oranges.

It says influenza kills 93 people per day in the US...how many people do you think influenza kills on July 4th? 93? What about July 6th?

It really shouldn't be necessary to explain that.
Title: Re: How long can we wait while flattening the curve?
Post by: runbikerun on April 07, 2020, 12:16:30 AM
The reason Covid-19 won't kill 900 people a day for a year is specifically because of the measures being taken to prevent it.

The numbers were offered to illustrate the fact that the virus is considerably more lethal than the common flu. I don't see any basis for arguing that the death rate doesn't demonstrate that horribly effectively.

I would also point out that since the 900-deaths-a-day figure was posted (which is almost guaranteed to be a severe underestimate), that figure has been exceeded every single day.

The question that was being discussed was how much more dangerous than the flu Covid-19 is. The post did a pretty effective job of demonstrating that it's vastly more dangerous.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on April 07, 2020, 07:06:33 AM
The reason Covid-19 won't kill 900 people a day for a year is specifically because of the measures being taken to prevent it.

The numbers were offered to illustrate the fact that the virus is considerably more lethal than the common flu. I don't see any basis for arguing that the death rate doesn't demonstrate that horribly effectively.

I would also point out that since the 900-deaths-a-day figure was posted (which is almost guaranteed to be a severe underestimate), that figure has been exceeded every single day.
The question that was being discussed was how much more dangerous than the flu Covid-19 is. The post did a pretty effective job of demonstrating that it's vastly more dangerous.

1. The post was not designed to do that, it was designed to take advantage of the naivette most people have when it comes to understanding #s. There's lies...damned lies...and statistics.
2. Is it really fair to compare a virus we have a vaccine for that still kills ~30-50k people in the US every year to a virus that we've never seen before and no one has natural anti-bodies to? Did you not expect it to be more deadly? Anyone attempting to make a straight comparison whether to downplay the deadliness of Sars-Cov2 or to do the exact opposite isn't being fully honest.
3. I'd argue it is overly effective at making your point because the flu is seasonal (i.e. 4 months of the year) and we don't know what this is yet. So to be completely fair you'd need to divide # of flu deaths by the # of days it's actively killing people, not over 365 days. All projections have this as killing 80-100k people in the US. If we divide that by 365 that's far fewer than 900/day 1100/day, etc.

My response is not meant to downplay the seriousness of Sars-Cov2 at all, but I'm not a big fan of misusing data to "scare" people into submission and if anything I think this downplays how lethal the flu actually is and the importance of getting the yearly vaccine.

When this is all over we'll be able to establish how "deadly" this virus really is, until then anyone's guess is just an opinion on incomplete data.

Even the model being used as the basis for CNN and the Whitehouse is already off by an order of magnitude. https://covid19.healthdata.org/united-states-of-america

The average death count on the 3 days since the updated model has come out has been over-estimating deaths by ~40%.

I'm glad the social distancing and shelter-in-place measures seem to be working, but remember at the end of the day we can't stay in our homes until we develop a vaccine, so if it's true this doesn't fade away in the summer like other viruses then there's a strong chance most of us will come into contact with it, unless of course, you're planning to shelter-in-place until ~2022.
Title: Re: How long can we wait while flattening the curve?
Post by: Davnasty on April 07, 2020, 08:54:31 AM
The reason Covid-19 won't kill 900 people a day for a year is specifically because of the measures being taken to prevent it.

The numbers were offered to illustrate the fact that the virus is considerably more lethal than the common flu. I don't see any basis for arguing that the death rate doesn't demonstrate that horribly effectively.

I would also point out that since the 900-deaths-a-day figure was posted (which is almost guaranteed to be a severe underestimate), that figure has been exceeded every single day.
The question that was being discussed was how much more dangerous than the flu Covid-19 is. The post did a pretty effective job of demonstrating that it's vastly more dangerous.

1. The post was not designed to do that, it was designed to take advantage of the naivette most people have when it comes to understanding #s. There's lies...damned lies...and statistics.
2. Is it really fair to compare a virus we have a vaccine for that still kills ~30-50k people in the US every year to a virus that we've never seen before and no one has natural anti-bodies to? Did you not expect it to be more deadly? Anyone attempting to make a straight comparison whether to downplay the deadliness of Sars-Cov2 or to do the exact opposite isn't being fully honest.
3. I'd argue it is overly effective at making your point because the flu is seasonal (i.e. 4 months of the year) and we don't know what this is yet. So to be completely fair you'd need to divide # of flu deaths by the # of days it's actively killing people, not over 365 days. All projections have this as killing 80-100k people in the US. If we divide that by 365 that's far fewer than 900/day 1100/day, etc.

My response is not meant to downplay the seriousness of Sars-Cov2 at all, but I'm not a big fan of misusing data to "scare" people into submission and if anything I think this downplays how lethal the flu actually is and the importance of getting the yearly vaccine.

When this is all over we'll be able to establish how "deadly" this virus really is, until then anyone's guess is just an opinion on incomplete data.

Even the model being used as the basis for CNN and the Whitehouse is already off by an order of magnitude. https://covid19.healthdata.org/united-states-of-america

The average death count on the 3 days since the updated model has come out has been over-estimating deaths by ~40%.

I'm glad the social distancing and shelter-in-place measures seem to be working, but remember at the end of the day we can't stay in our homes until we develop a vaccine, so if it's true this doesn't fade away in the summer like other viruses then there's a strong chance most of us will come into contact with it, unless of course, you're planning to shelter-in-place until ~2022.

I'm curious what the daily death rate due to brain aneurysm is for epidemiologists trying to explain statistics...

Nereo was right from the beginning that daily deaths just shouldn't be compared between chronic problems and a pandemic. I realize JGS was making a specific point, but I really don't think there's any context where that comparison tells us anything useful.

But then suggesting that the daily mortality rate be determined by taking total deaths and dividing by the number of days so far in 2020? That's completely arbitrary. The first death in the US was February 29, so I guess on 2/29/20 the daily mortality rate was .016? Obviously that makes no sense.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on April 07, 2020, 10:54:18 AM
The reason Covid-19 won't kill 900 people a day for a year is specifically because of the measures being taken to prevent it.

The numbers were offered to illustrate the fact that the virus is considerably more lethal than the common flu. I don't see any basis for arguing that the death rate doesn't demonstrate that horribly effectively.

I would also point out that since the 900-deaths-a-day figure was posted (which is almost guaranteed to be a severe underestimate), that figure has been exceeded every single day.
The question that was being discussed was how much more dangerous than the flu Covid-19 is. The post did a pretty effective job of demonstrating that it's vastly more dangerous.

1. The post was not designed to do that, it was designed to take advantage of the naivette most people have when it comes to understanding #s. There's lies...damned lies...and statistics.
2. Is it really fair to compare a virus we have a vaccine for that still kills ~30-50k people in the US every year to a virus that we've never seen before and no one has natural anti-bodies to? Did you not expect it to be more deadly? Anyone attempting to make a straight comparison whether to downplay the deadliness of Sars-Cov2 or to do the exact opposite isn't being fully honest.
3. I'd argue it is overly effective at making your point because the flu is seasonal (i.e. 4 months of the year) and we don't know what this is yet. So to be completely fair you'd need to divide # of flu deaths by the # of days it's actively killing people, not over 365 days. All projections have this as killing 80-100k people in the US. If we divide that by 365 that's far fewer than 900/day 1100/day, etc.

My response is not meant to downplay the seriousness of Sars-Cov2 at all, but I'm not a big fan of misusing data to "scare" people into submission and if anything I think this downplays how lethal the flu actually is and the importance of getting the yearly vaccine.

When this is all over we'll be able to establish how "deadly" this virus really is, until then anyone's guess is just an opinion on incomplete data.

Even the model being used as the basis for CNN and the Whitehouse is already off by an order of magnitude. https://covid19.healthdata.org/united-states-of-america

The average death count on the 3 days since the updated model has come out has been over-estimating deaths by ~40%.

I'm glad the social distancing and shelter-in-place measures seem to be working, but remember at the end of the day we can't stay in our homes until we develop a vaccine, so if it's true this doesn't fade away in the summer like other viruses then there's a strong chance most of us will come into contact with it, unless of course, you're planning to shelter-in-place until ~2022.

I'm curious what the daily death rate due to brain aneurysm is for epidemiologists trying to explain statistics...

Nereo was right from the beginning that daily deaths just shouldn't be compared between chronic problems and a pandemic. I realize JGS was making a specific point, but I really don't think there's any context where that comparison tells us anything useful.

But then suggesting that the daily mortality rate be determined by taking total deaths and dividing by the number of days so far in 2020? That's completely arbitrary. The first death in the US was February 29, so I guess on 2/29/20 the daily mortality rate was .016? Obviously that makes no sense.

That's why you can't compare daily mortality rates as they are happening. So trying to do so with anything doesn't make sense as they are averages across a year. Let's use your example and start on Feb. 29 with the first death, the second death didn't happen until March 2nd. So is the daily death rate for Sars-Cov2 on March 1st 0.5?

Even if you use Feb 29 to yesterday we are still only at 286 deaths per day, nowhere near the 900 reported in the "comparison"

Title: Re: How long can we wait while flattening the curve?
Post by: Davnasty on April 07, 2020, 11:07:59 AM

That's why you can't compare daily mortality rates as they are happening. So trying to do so with anything doesn't make sense as they are averages across a year. Let's use your example and start on Feb. 29 with the first death, the second death didn't happen until March 2nd. So is the daily death rate for Sars-Cov2 on March 1st 0.5?

Even if you use Feb 29 to yesterday we are still only at 286 deaths per day, nowhere near the 900 reported in the "comparison"

So we agree. I think we could have just left it at this though. The year to date daily average you gave earlier was completely arbitrary.

If your point was to say, look at how meaningless this number is then you were correct. Just seems like a weird way to show it.
Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on April 07, 2020, 11:23:39 AM

That's why you can't compare daily mortality rates as they are happening. So trying to do so with anything doesn't make sense as they are averages across a year. Let's use your example and start on Feb. 29 with the first death, the second death didn't happen until March 2nd. So is the daily death rate for Sars-Cov2 on March 1st 0.5?

Even if you use Feb 29 to yesterday we are still only at 286 deaths per day, nowhere near the 900 reported in the "comparison"

So we agree. I think we could have just left it at this though. The year to date daily average you gave earlier was completely arbitrary.

If your point was to say, look at how meaningless this number is then you were correct. Just seems like a weird way to show it.

I was simply saying it's a more honest comparison than taking the peak deaths to date and comparing it to averages for a year for all other causes of death.

But yes we agree, it's a meaningless comparison, which was my main point.
Title: Re: How long can we wait while flattening the curve?
Post by: Travis on April 07, 2020, 05:38:12 PM

That's why you can't compare daily mortality rates as they are happening. So trying to do so with anything doesn't make sense as they are averages across a year. Let's use your example and start on Feb. 29 with the first death, the second death didn't happen until March 2nd. So is the daily death rate for Sars-Cov2 on March 1st 0.5?

Even if you use Feb 29 to yesterday we are still only at 286 deaths per day, nowhere near the 900 reported in the "comparison"

So we agree. I think we could have just left it at this though. The year to date daily average you gave earlier was completely arbitrary.

If your point was to say, look at how meaningless this number is then you were correct. Just seems like a weird way to show it.

I was simply saying it's a more honest comparison than taking the peak deaths to date and comparing it to averages for a year for all other causes of death.

But yes we agree, it's a meaningless comparison, which was my main point.

55% of all statistics are made up anyways.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 07, 2020, 05:44:50 PM

That's why you can't compare daily mortality rates as they are happening. So trying to do so with anything doesn't make sense as they are averages across a year. Let's use your example and start on Feb. 29 with the first death, the second death didn't happen until March 2nd. So is the daily death rate for Sars-Cov2 on March 1st 0.5?

Even if you use Feb 29 to yesterday we are still only at 286 deaths per day, nowhere near the 900 reported in the "comparison"

So we agree. I think we could have just left it at this though. The year to date daily average you gave earlier was completely arbitrary.

If your point was to say, look at how meaningless this number is then you were correct. Just seems like a weird way to show it.

I was simply saying it's a more honest comparison than taking the peak deaths to date and comparing it to averages for a year for all other causes of death.

But yes we agree, it's a meaningless comparison, which was my main point.

55% of all statistics are made up anyways.
Only 90% of the time.
Title: Re: How long can we wait while flattening the curve?
Post by: Sanitary Engineer on April 08, 2020, 12:17:07 PM
I lost track of where this thread is going, are there any guesses on how long we can last while flattening the curve?  I get the sense from people I talk to that we will be shut down through July and these expectations keep extending.  I guess my family would be good for two years with the current benefits availabe through unemployment and loan forebearance. 

I assume we will have a workable testing scenario in place within two years that allows mostly normal behavior with rapid detection of developing hot spots and rolling stay at home guidance by region.  It is too bad our government is subservient to money interests though becuase we could probably end up with a much more resilient society than we have currently.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 08, 2020, 12:26:18 PM
I lost track of where this thread is going, are there any guesses on how long we can last while flattening the curve?  I get the sense from people I talk to that we will be shut down through July and these expectations keep extending.  I guess my family would be good for two years with the current benefits availabe through unemployment and loan forebearance. 


I think speculation beyond 6 weeks is not practical.  Certainly some countries and regions have gained control over this virus in about that amount of time, and the nature of exponential growth is there's a huge amount of uncertainty when you go beyond a handful of potential doublings.

There's also at least some hope that by early July (~12 weeks from now) our manufacturing capabilities will finally have caught up to demand with regards to PPE and rapid-assessment testing, both of which are needed to really curtail the spread.

Of course we could continue to royally screw up our response and chase false hopes.  There's reason for pessimism too...

Title: Re: How long can we wait while flattening the curve?
Post by: mizzourah2006 on April 08, 2020, 12:45:10 PM
Obviously models are just that...but the one that most seem to be referencing is projecting a peak in deaths this Sunday for the entirety of the US, obviously individual states will differ. They've also significantly reduced the total # of deaths projected through the beginning of August over the past week. It's cause for some hopeful optimism.

https://covid19.healthdata.org/united-states-of-america

Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate on April 08, 2020, 01:05:40 PM
Obviously models are just that...but the one that most seem to be referencing is projecting a peak in deaths this Sunday for the entirety of the US, obviously individual states will differ. They've also significantly reduced the total # of deaths projected through the beginning of August over the past week. It's cause for some hopeful optimism.

https://covid19.healthdata.org/united-states-of-america

Also, it's still rather early, but it does look like April 3rd may have been the inflection point (where 2nd derv. goes neg) for the number of cases in the US.
https://coronavirus.jhu.edu/map.html (https://coronavirus.jhu.edu/map.html)
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 08, 2020, 02:58:31 PM
I’ve been tracking the case and death numbers in Spain, Italy, NY/NJ, etc and they all follow a similar pattern in terms of a rapid increase in deaths per day, then a plateau. Italy is still having about 600-800 deaths a day with only a small sign of a drop after 2 weeks. It is not a symmetric peak by any means, more of a sharp uptick and a slow taper down
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 08, 2020, 06:37:36 PM
I’ve been tracking the case and death numbers in Spain, Italy, NY/NJ, etc and they all follow a similar pattern in terms of a rapid increase in deaths per day, then a plateau. Italy is still having about 600-800 deaths a day with only a small sign of a drop after 2 weeks. It is not a symmetric peak by any means, more of a sharp uptick and a slow taper down

That plateau is a result of the stringent lockdown. It doesnt just happen. Without it, you would continue to see the rapid increase.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on April 08, 2020, 07:19:59 PM
Interesting that in the past few days there has been a significant drop in the projected number of cases and fatalities to the extent that Virginia might even squeak by with enough ventilators. 

We know what we know and in Virginia, the shut down extends until June 10th, unless changed.  I think Virginia has been unusually forthright in their expectations rather than teasing an early date and then extending it further. I think this goes until early June, with massive but not quite Biblical levels of damage to the US economy.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 08, 2020, 09:26:18 PM
I’ve been tracking the case and death numbers in Spain, Italy, NY/NJ, etc and they all follow a similar pattern in terms of a rapid increase in deaths per day, then a plateau. Italy is still having about 600-800 deaths a day with only a small sign of a drop after 2 weeks. It is not a symmetric peak by any means, more of a sharp uptick and a slow taper down

That plateau is a result of the stringent lockdown. It doesnt just happen. Without it, you would continue to see the rapid increase.

I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on April 09, 2020, 06:21:10 AM
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

Three weeks later, here are two reports of “moderate” cases in otherwise healthy non-elderly American adults. Does anyone still believe that this wouldn’t have wreaked havoc on society even if we hadn’t shut things down?

https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html (https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html)

https://affordanything.com/i-tested-positive-for-coronavirus/ (https://affordanything.com/i-tested-positive-for-coronavirus/)
Title: Re: How long can we wait while flattening the curve?
Post by: KBecks on April 09, 2020, 08:36:35 AM
Here's a really cool site that one of my friends shared. You can look at the data, resources, deaths and projected curves for different countries and US States.  I have it set to my state, but you can change the location at the top:

https://covid19.healthdata.org/united-states-of-america/wisconsin?fbclid=IwAR2lKCOYNyolfNOVw0z1-1jSo10wXYTsY1MnV1UigaejVUfeLcEds3aCr4I



Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on April 09, 2020, 02:02:44 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

Three weeks later, here are two reports of “moderate” cases in otherwise healthy non-elderly American adults. Does anyone still believe that this wouldn’t have wreaked havoc on society even if we hadn’t shut things down?

https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html (https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html)

https://affordanything.com/i-tested-positive-for-coronavirus/ (https://affordanything.com/i-tested-positive-for-coronavirus/)

I don't think many are naive enough to say that this wouldn't impact every demographic, but odds are far worse for some demographics than others. Of course there are a few cases in young, healthy people but if you're younger, you're less likely to have symptoms, and if you do, they're less likely to be severe. Pointing out the rare case of COVID in a young person is just latching onto a statistical anomaly to grab clicks and foster fear. In other words, no demographic has zero risk, but there are very clearly some demographics at more risk than others. Lets be honest about the odds.

Most states are tracking cases and deaths pretty closely and sharing data that usually includes demographics. Since you're in Michigan, let's look at their site here:

https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html

Highlights from that link:

21,504 confirmed cases. 1076 deaths as of 3pm today.
Ages of deceased range from 20-107 years old but the median age of deceased patients is 73 years old.
People age 19 and under represent 1% of total cases and 0% of deaths from COVID-19
People in their 20s represent 9% of total cases and 1% of deaths
People in their 30s represent 13% of total cases and 2% of deaths
People in their 40s represent 17% of total cases and 5% of deaths
People in their 50s represent 20% of total cases and 11% of deaths
People in their 60s represent 18% of total cases and 21% of deaths
People in their 70s represent 13% of total cases and 28% of deaths
People 80+ represent 9% of confirmed cases but 34% of deaths
Title: Re: How long can we wait while flattening the curve?
Post by: Laserjet3051 on April 09, 2020, 02:15:36 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

Three weeks later, here are two reports of “moderate” cases in otherwise healthy non-elderly American adults. Does anyone still believe that this wouldn’t have wreaked havoc on society even if we hadn’t shut things down?

https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html (https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html)

https://affordanything.com/i-tested-positive-for-coronavirus/ (https://affordanything.com/i-tested-positive-for-coronavirus/)

I don't think many are naive enough to say that this wouldn't impact every demographic, but odds are far worse for some demographics than others. Of course there are a few cases in young, healthy people but if you're younger, you're less likely to have symptoms, and if you do, they're less likely to be severe. Pointing out the rare case of COVID in a young person is just latching onto a statistical anomaly to grab clicks and foster fear. In other words, no demographic has zero risk, but there are very clearly some demographics at more risk than others. Lets be honest about the odds.

Most states are tracking cases and deaths pretty closely and sharing data that usually includes demographics. Since you're in Michigan, let's look at their site here:

https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html

Highlights from that link:

Ages of confirmed cases range from 20-107 years old but the median age of deceased patients is 73 years old in MI.
People age 19 and under represent 1% of total cases and 0% of deaths from COVID-19
People in their 20s represent 9% of total cases and 1% of deaths
People in their 30s represent 13% of total cases and 2% of deaths
People in their 40s represent 17% of total cases and 5% of deaths
People in their 50s represent 20% of total cases and 11% of deaths
People in their 60s represent 18% of total cases and 21% of deaths
People in their 70s represent 13% of total cases and 28% of deaths
People 80+ represent 9% of confirmed cases but 34% of deaths

unfortunately most people dont have even a basic understanding of statistical probalilities and how that relates to real risk. look at the hysteria. omg, a healthy kid died? ITEOTWAWKI!! fact is i live in a county in MI that has single digit covid death count and very low double digit inpatient counts with a total population well over 2.5e5. put that risk into context, factor in no comorbidities and my age and i have a higher risk of being gored by a moose than succumbing to covid. similar scenario for many millions of other americans. but the hysterical fear mongers who have 0 understanding of risk are the loudest in the crowd. Did i mention my job is to understand safety risks of "treatments" in populations, where some of said treatments are viral? we all have to look and dig deep into the truth that lies in the numbers and respond accordingly.
Title: Re: How long can we wait while flattening the curve?
Post by: the_gastropod on April 09, 2020, 02:36:08 PM
unfortunately most people dont have even a basic understanding of statistical probalilities and how that relates to real risk. look at the hysteria. omg, a healthy kid died? ITEOTWAWKI!! fact is i live in a county in MI that has single digit covid death count and very low double digit inpatient counts with a total population well over 2.5e5. put that risk into context, factor in no comorbidities and my age and i have a higher risk of being gored by a moose than succumbing to covid. similar scenario for many millions of other americans. but the hysterical fear mongers who have 0 understanding of risk are the loudest in the crowd. Did i mention my job is to understand safety risks of "treatments" in populations, where some of said treatments are viral? we all have to look and dig deep into the truth that lies in the numbers and respond accordingly.

C'mon. Statistical probabilities for an unknown virus, while infections are exponentially increasing aren't really a thing. FiveThirtyEight has a good read here (https://fivethirtyeight.com/features/why-its-so-freaking-hard-to-make-a-good-covid-19-model/) explaining the difficulty in modeling this. Fooling yourself into thinking you have anything close to accurate statistics based on past deaths in a state where this thing hasn't even begun in earnest is, well, foolish. Coronavirus is the leading cause of death in the U.S. as of today. You are as wrong as you are confident.
Title: Re: How long can we wait while flattening the curve?
Post by: js82 on April 09, 2020, 03:14:09 PM
I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.

The probable outcome from my perspective is that we have a harsh lockdown for another 1-2 months until the "hotspots" are under control, then a gradual, controlled loosening.  Once the virus is at relatively low levels we don't need to reduce transmission to zero, but we do still need to keep it low enough that the total number of cases continues to decline.

What does this look like? 

Probably some businesses reopening, but with reduced occupancy and/or other rules in place to reduce transmission risk.  Low risk transmission spots will reopen - things like golf courses, hiking spots, etc - places where people can safely stay spread out.  Things that pack a lot of people into a small space like theaters, concerts, and sporting events will stay closed for a while if we have any sense at all(and even if they're open, a lot of people won't be going there until this whole thing settles down)

And this all still requires a lot more testing and contact tracing than we're doing right now.  Making this work requires that we identify cases and quarantine them and people they've had contact with until we're sure they're negative for the virus.  "If you feel even slightly sick, stay the F home" needs to be the expectation until we have a vaccine.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 09, 2020, 05:13:38 PM
It will be interesting to see if some regions or companies get a huge advantage over others should one open weeks before another. One could imagine a single company in a favorable region could gobble up market share while their competitors remained under forced closures.

This might play out internationally to, of course.
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on April 09, 2020, 06:22:49 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

Three weeks later, here are two reports of “moderate” cases in otherwise healthy non-elderly American adults. Does anyone still believe that this wouldn’t have wreaked havoc on society even if we hadn’t shut things down?

https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html (https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html)

https://affordanything.com/i-tested-positive-for-coronavirus/ (https://affordanything.com/i-tested-positive-for-coronavirus/)

I don't think many are naive enough to say that this wouldn't impact every demographic, but odds are far worse for some demographics than others. Of course there are a few cases in young, healthy people but if you're younger, you're less likely to have symptoms, and if you do, they're less likely to be severe. Pointing out the rare case of COVID in a young person is just latching onto a statistical anomaly to grab clicks and foster fear. In other words, no demographic has zero risk, but there are very clearly some demographics at more risk than others. Lets be honest about the odds.

Most states are tracking cases and deaths pretty closely and sharing data that usually includes demographics. Since you're in Michigan, let's look at their site here:

https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html

Highlights from that link:

21,504 confirmed cases. 1076 deaths as of 3pm today.
Ages of deceased range from 20-107 years old but the median age of deceased patients is 73 years old.
People age 19 and under represent 1% of total cases and 0% of deaths from COVID-19
People in their 20s represent 9% of total cases and 1% of deaths
People in their 30s represent 13% of total cases and 2% of deaths
People in their 40s represent 17% of total cases and 5% of deaths
People in their 50s represent 20% of total cases and 11% of deaths
People in their 60s represent 18% of total cases and 21% of deaths
People in their 70s represent 13% of total cases and 28% of deaths
People 80+ represent 9% of confirmed cases but 34% of deaths

Yeah, you completely missed my point. Even if no one died, the reports I linked describe “moderate” cases. These people have been incapacitated for weeks. This is a highly contagious virus. The economy would have taken a major hit whether or not everything was shut down by state governments.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 09, 2020, 11:25:39 PM
Regarding letting the virus burn through the population (rip the bandaid off approach):

Using data from South Korea, which has done widespread testing of asymptomatic people to get the most accurate fatality rate available (https://www.ijidonline.com/article/S1201-9712(20)30150-8/fulltext)
and the US population distribution (https://www.census.gov/prod/cen2010/briefs/c2010br-03.pdf) and assuming an infection rate of 50-100% (Imperial College estimated about 80% of total population would get infected without mitigation)

I calculated mortality figures for age groups as:
<30: negligible
30-39: 22,000 to 44,000
40-49: 20-40k
50-59: 84-168k

So the working population could lose 126k-252k people. Total deaths from all causes on average for those age groups per year in US is 450-500k.

For 60+ its worse:
60-69: 200-400k
70-79: 340-680k
80-89: 320-640k

861k to 1.7m deaths in these groups, compared to 1.9m per year for all causes.

Overall deaths in US is 2.4m per year from all causes. Adding another 1m to 2.2m is a big hit. Deaths from influenza are ~35k per year.  I have a hard time imagining that this many deaths would not cause a huge dent in the economy on par with a recession.

Another things to consider is the hospitalization rate. In NYC it is currently 0.3% (https://www1.nyc.gov/site/doh/covid/covid-19-data.page). Keep in mind this is over the course of 3 weeks in the upswing of an epidemic.

0.3% * 327,000,000 = 837,000 hospitalizations. That is approximately the total number of hospital beds in the entire country. Average hospitalizations for the flu over a year (not a month) in the US over the last decade was 440k. (https://www.cdc.gov/flu/about/burden/past-seasons.html)

Obviously using our entire hospital capacity for only COVID patients would collapse our healthcare system, likely kill several thousand healthcare workers & thus crush our system for years to come, and likely result in thousands of additional deaths due to lack of critical care for other illnesses, etc. Not to mention no one would want to work in healthcare in such a cruel system. Losing 18% of our entire GDP (healthcare's contribution) would definitely cause a serious recession.

Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 09, 2020, 11:29:56 PM
I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.

The probable outcome from my perspective is that we have a harsh lockdown for another 1-2 months until the "hotspots" are under control, then a gradual, controlled loosening.  Once the virus is at relatively low levels we don't need to reduce transmission to zero, but we do still need to keep it low enough that the total number of cases continues to decline.

What does this look like? 

Probably some businesses reopening, but with reduced occupancy and/or other rules in place to reduce transmission risk.  Low risk transmission spots will reopen - things like golf courses, hiking spots, etc - places where people can safely stay spread out.  Things that pack a lot of people into a small space like theaters, concerts, and sporting events will stay closed for a while if we have any sense at all(and even if they're open, a lot of people won't be going there until this whole thing settles down)

And this all still requires a lot more testing and contact tracing than we're doing right now.  Making this work requires that we identify cases and quarantine them and people they've had contact with until we're sure they're negative for the virus.  "If you feel even slightly sick, stay the F home" needs to be the expectation until we have a vaccine.

I agree with you on all of the above, and it seems that is the plan in Europe once things stabilize there. Hopefully testing will ramp up soon in the US. Vaccine trials are underway.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 10, 2020, 04:24:32 AM
I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.

The probable outcome from my perspective is that we have a harsh lockdown for another 1-2 months until the "hotspots" are under control, then a gradual, controlled loosening.  Once the virus is at relatively low levels we don't need to reduce transmission to zero, but we do still need to keep it low enough that the total number of cases continues to decline.

What does this look like? 

Probably some businesses reopening, but with reduced occupancy and/or other rules in place to reduce transmission risk.  Low risk transmission spots will reopen - things like golf courses, hiking spots, etc - places where people can safely stay spread out.  Things that pack a lot of people into a small space like theaters, concerts, and sporting events will stay closed for a while if we have any sense at all(and even if they're open, a lot of people won't be going there until this whole thing settles down)

And this all still requires a lot more testing and contact tracing than we're doing right now.  Making this work requires that we identify cases and quarantine them and people they've had contact with until we're sure they're negative for the virus.  "If you feel even slightly sick, stay the F home" needs to be the expectation until we have a vaccine.

I agree with you on all of the above, and it seems that is the plan in Europe once things stabilize there. Hopefully testing will ramp up soon in the US. Vaccine trials are underway.

I don't quite understand the optimism about this vaccine. We still don't have a vaccine for SARs, that this is most similar to.....
Title: Re: How long can we wait while flattening the curve?
Post by: YttriumNitrate on April 10, 2020, 05:24:59 AM
I don't quite understand the optimism about this vaccine. We still don't have a vaccine for SARs, that this is most similar to.....
Compared to a Covid-19 vaccine, do you think 1/1000th the resources are being devoted to a SARS vaccine? I'd be quite surprised if yesterday alone more money wasn't spent developing a Covid-19 vaccine than was ever spent on a SARS vaccine.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 05:58:40 AM
I don't quite understand the optimism about this vaccine. We still don't have a vaccine for SARs, that this is most similar to.....
Compared to a Covid-19 vaccine, do you think 1/1000th the resources are being devoted to a SARS vaccine? I'd be quite surprised if yesterday alone more money wasn't spent developing a Covid-19 vaccine than was ever spent on a SARS vaccine.

I don’t think there’s a linear relationship between vaccine development and money allocated.  By which I mean spending 1000x doesn’t get you a vaccine 1000x faster.  Sure, throwing more resources at a disease certainly helps, but the complexity remains.  There’s no certainty that an effective vaccine will be developed and readily available by next year, or even the following year. 
Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on April 10, 2020, 06:08:57 AM
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

Three weeks later, here are two reports of “moderate” cases in otherwise healthy non-elderly American adults. Does anyone still believe that this wouldn’t have wreaked havoc on society even if we hadn’t shut things down?

https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html (https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html)

https://affordanything.com/i-tested-positive-for-coronavirus/ (https://affordanything.com/i-tested-positive-for-coronavirus/)

I don't think many are naive enough to say that this wouldn't impact every demographic, but odds are far worse for some demographics than others. Of course there are a few cases in young, healthy people but if you're younger, you're less likely to have symptoms, and if you do, they're less likely to be severe. Pointing out the rare case of COVID in a young person is just latching onto a statistical anomaly to grab clicks and foster fear. In other words, no demographic has zero risk, but there are very clearly some demographics at more risk than others. Lets be honest about the odds.

Most states are tracking cases and deaths pretty closely and sharing data that usually includes demographics. Since you're in Michigan, let's look at their site here:

https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html

Highlights from that link:

21,504 confirmed cases. 1076 deaths as of 3pm today.
Ages of deceased range from 20-107 years old but the median age of deceased patients is 73 years old.
People age 19 and under represent 1% of total cases and 0% of deaths from COVID-19
People in their 20s represent 9% of total cases and 1% of deaths
People in their 30s represent 13% of total cases and 2% of deaths
People in their 40s represent 17% of total cases and 5% of deaths
People in their 50s represent 20% of total cases and 11% of deaths
People in their 60s represent 18% of total cases and 21% of deaths
People in their 70s represent 13% of total cases and 28% of deaths
People 80+ represent 9% of confirmed cases but 34% of deaths

Yeah, you completely missed my point. Even if no one died, the reports I linked describe “moderate” cases. These people have been incapacitated for weeks. This is a highly contagious virus. The economy would have taken a major hit whether or not everything was shut down by state governments.

And you completely missed my point. The odds of a young person seeing moderate symptoms are pretty darn low. They broadcast a handful of stories about them specifically because it's uncommon and newsworthy.

I don't think there's any question that the economy still would've been impacted by the virus without shutdowns. But what is in question is how severe that impact might've been. If a business owner loses a percentage of their employees and customers due to symptoms of being ill or fears of venturing into public, is that better than having the business essentially closed (or fully closed) by a mandated shutdown? Would a business rather stay open for the healthy 60% of its staff and 30-50% of it's normal revenue, or would they rather lay nearly everybody off, and have little or no revenue? Is some commerce better than no commerce for a small business?
Title: Re: How long can we wait while flattening the curve?
Post by: KBecks on April 10, 2020, 06:12:50 AM
I was listening to a business update conference call for a publicly traded company that I invest in and they are operating their warehouses at limited levels, with social distancing and employee attendance is optional. They have given everyone 4 weeks of time off that they can take at their discretion.  They are also doing temperature checks at their warehouses and providing more medical support on site.  The company is using its cut and sewing facility in Pennsylvania to make medical masks which will start being delivered next week.

So they are functioning, but at a slower pace than in normal times.  This sounds like a perfect way to continue the business, and the business and its employees are deciding what is safe for them during these unusual times.  The company is well funded and they are able to run their business carefully at limited capacity.

Title: Re: How long can we wait while flattening the curve?
Post by: frugalnacho on April 10, 2020, 07:36:58 AM
Nobody gave a fuck about SARS.  That's not completely true, some people did, but by and large nobody gave a fuck about SARS.  SARS was an abstract thing that happened to other people, in another country, on another continent, and to most people it was nothing more than a blip in the news and some clips of some asian people wearing masks.  Total world wide deaths ended up being 774, largely concentrated in a handful of countries.  That's the same amount of deaths that occur due to traffic fatalities in the USA on an average week.  I vaguely remember the SARS epidemic, but it really didn't affect my life at all, and I think that's true of almost the entire population.  If you had a low information diet you may have even been completely unaware of SARS at all. 

Coronavirus however now has the entire world's attention.  In terms of infections, deaths, and disruption to people's lives the coronavirus is many, many orders of magnitude larger. We have more cases and deaths from coronavirus just in the metro detroit region than SARS had worldwide, and the pandemic is still raging on while we haven't had a single SARS case since 2003. I can't believe the resources being poured into SARS were even remotely comparable to the resources being poured into the coronavirus.  The entire species is focussing like a laser on the coronavirus, and if a vaccine is possible it will surely be developed, and in record time too.  Multiple trials have already started.  We are witnessing history in the making both in terms of the pandemic, and of what we as a species are capable of accomplishing.
Title: Re: How long can we wait while flattening the curve?
Post by: cerat0n1a on April 10, 2020, 08:34:06 AM
I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.

The probable outcome from my perspective is that we have a harsh lockdown for another 1-2 months until the "hotspots" are under control, then a gradual, controlled loosening.  Once the virus is at relatively low levels we don't need to reduce transmission to zero, but we do still need to keep it low enough that the total number of cases continues to decline.

What does this look like? 

Probably some businesses reopening, but with reduced occupancy and/or other rules in place to reduce transmission risk.  Low risk transmission spots will reopen - things like golf courses, hiking spots, etc - places where people can safely stay spread out.  Things that pack a lot of people into a small space like theaters, concerts, and sporting events will stay closed for a while if we have any sense at all(and even if they're open, a lot of people won't be going there until this whole thing settles down)


One of the options that's been suggested/ modeled here is that you let anyone 18-40 who doesn't live with their parents go out to work & low density spaces. It's a reasonable percentage of the working population and although obviously there will be some deaths, it doesn't overwhelm hospitals. After a period, you start upping the age curfew slowly. Possibly hard to implement though.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 08:35:04 AM

And you completely missed my point. The odds of a young person seeing moderate symptoms are pretty darn low. They broadcast a handful of stories about them specifically because it's uncommon and newsworthy.

I don't think there's any question that the economy still would've been impacted by the virus without shutdowns. But what is in question is how severe that impact might've been. If a business owner loses a percentage of their employees and customers due to symptoms of being ill or fears of venturing into public, is that better than having the business essentially closed (or fully closed) by a mandated shutdown? Would a business rather stay open for the healthy 60% of its staff and 30-50% of it's normal revenue, or would they rather lay nearly everybody off, and have little or no revenue? Is some commerce better than no commerce for a small business?

Hmm... the data shows otherwise.  It's certainly true that the likelihood of a young person who's contracted the virus of dying are low (i.e. mortality rate), but a large portion still get moderate symptoms.  And with an illness like this one, 'moderate symptoms' are strong enough to curtail normal function for several days.

As many people can be asymptomatic or mildly symptomatic carriers, and as we currently have no way of knowing what percentage of employees are truly 'healthy' and safe to work, it's not a scenario we are capable of judging right now. There's also enough variance among 'small businesses' that one cannot answer which would be better - total shutdown or operating at reduced capacity (assuming we could know which employees and clients were 'safe' to do business with). Some small businesses can easily be mothballed.  Others have substantial overhead and low cash reserves and will suffer.  Thankfully my previous business (which I have an equity stake in) is among the former.
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on April 10, 2020, 08:41:35 AM
I don't quite understand the optimism about this vaccine. We still don't have a vaccine for SARs, that this is most similar to.....
Compared to a Covid-19 vaccine, do you think 1/1000th the resources are being devoted to a SARS vaccine? I'd be quite surprised if yesterday alone more money wasn't spent developing a Covid-19 vaccine than was ever spent on a SARS vaccine.

I don’t think there’s a linear relationship between vaccine development and money allocated.  By which I mean spending 1000x doesn’t get you a vaccine 1000x faster.  Sure, throwing more resources at a disease certainly helps, but the complexity remains.  There’s no certainty that an effective vaccine will be developed and readily available by next year, or even the following year.

They are going to start DOZENS of Covid19 Vaccine trials in the next couple months. Forget the humanitarian aspects and prestige aspects of developing a safe and effective vaccine. Imagine the monetary benefits of a vaccine that the ENTIRE WORLD POPULATION is demanding. Jonas Salk provided his Polio vaccine free of charge 65 years ago, do we cynics think that will be the case this time around?
Title: Re: How long can we wait while flattening the curve?
Post by: former player on April 10, 2020, 08:54:33 AM
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

Three weeks later, here are two reports of “moderate” cases in otherwise healthy non-elderly American adults. Does anyone still believe that this wouldn’t have wreaked havoc on society even if we hadn’t shut things down?

https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html (https://www.nytimes.com/2020/03/24/magazine/coronavirus-family.html)

https://affordanything.com/i-tested-positive-for-coronavirus/ (https://affordanything.com/i-tested-positive-for-coronavirus/)

I don't think many are naive enough to say that this wouldn't impact every demographic, but odds are far worse for some demographics than others. Of course there are a few cases in young, healthy people but if you're younger, you're less likely to have symptoms, and if you do, they're less likely to be severe. Pointing out the rare case of COVID in a young person is just latching onto a statistical anomaly to grab clicks and foster fear. In other words, no demographic has zero risk, but there are very clearly some demographics at more risk than others. Lets be honest about the odds.

Most states are tracking cases and deaths pretty closely and sharing data that usually includes demographics. Since you're in Michigan, let's look at their site here:

https://www.michigan.gov/coronavirus/0,9753,7-406-98163_98173---,00.html

Highlights from that link:

21,504 confirmed cases. 1076 deaths as of 3pm today.
Ages of deceased range from 20-107 years old but the median age of deceased patients is 73 years old.
People age 19 and under represent 1% of total cases and 0% of deaths from COVID-19
People in their 20s represent 9% of total cases and 1% of deaths
People in their 30s represent 13% of total cases and 2% of deaths
People in their 40s represent 17% of total cases and 5% of deaths
People in their 50s represent 20% of total cases and 11% of deaths
People in their 60s represent 18% of total cases and 21% of deaths
People in their 70s represent 13% of total cases and 28% of deaths
People 80+ represent 9% of confirmed cases but 34% of deaths

Yeah, you completely missed my point. Even if no one died, the reports I linked describe “moderate” cases. These people have been incapacitated for weeks. This is a highly contagious virus. The economy would have taken a major hit whether or not everything was shut down by state governments.

And you completely missed my point. The odds of a young person seeing moderate symptoms are pretty darn low. They broadcast a handful of stories about them specifically because it's uncommon and newsworthy.

Separately from the scattered news reports of younger people with moderate or severe symptoms there seems also to be a high number of young fit people working on the frontline of covid-19 healthcare who are suffering moderate or severe symptoms.  That suggests to me that young fit people who are getting a high load of virus may be at significantly higher risk than the general statistics would suggest.  So any young person who doesn't at least try to limit their exposure could be running a higher risk than they would think based on the general statistics.
Title: Re: How long can we wait while flattening the curve?
Post by: sehr on April 10, 2020, 08:55:34 AM
I don't quite understand the optimism about this vaccine. We still don't have a vaccine for SARs, that this is most similar to.....
Compared to a Covid-19 vaccine, do you think 1/1000th the resources are being devoted to a SARS vaccine? I'd be quite surprised if yesterday alone more money wasn't spent developing a Covid-19 vaccine than was ever spent on a SARS vaccine.

I don’t think there’s a linear relationship between vaccine development and money allocated.  By which I mean spending 1000x doesn’t get you a vaccine 1000x faster.  Sure, throwing more resources at a disease certainly helps, but the complexity remains.  There’s no certainty that an effective vaccine will be developed and readily available by next year, or even the following year.

They are going to start DOZENS of Covid19 Vaccine trials in the next couple months. Forget the humanitarian aspects and prestige aspects of developing a safe and effective vaccine. Imagine the monetary benefits of a vaccine that the ENTIRE WORLD POPULATION is demanding. Jonas Salk provided his Polio vaccine free of charge 65 years ago, do we cynics think that will be the case this time around?

I think that depends on who ends up developing it. Bill Gates seems to be a leader in vaccine funding  and his life goal is to give half his fortune away, so if he funds a winner and builds its infrastructure for manufacturing, it should at least be free to developing nations.
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on April 10, 2020, 08:57:50 AM
I don't quite understand the optimism about this vaccine. We still don't have a vaccine for SARs, that this is most similar to.....
Compared to a Covid-19 vaccine, do you think 1/1000th the resources are being devoted to a SARS vaccine? I'd be quite surprised if yesterday alone more money wasn't spent developing a Covid-19 vaccine than was ever spent on a SARS vaccine.

I don’t think there’s a linear relationship between vaccine development and money allocated.  By which I mean spending 1000x doesn’t get you a vaccine 1000x faster.  Sure, throwing more resources at a disease certainly helps, but the complexity remains.  There’s no certainty that an effective vaccine will be developed and readily available by next year, or even the following year.

They are going to start DOZENS of Covid19 Vaccine trials in the next couple months. Forget the humanitarian aspects and prestige aspects of developing a safe and effective vaccine. Imagine the monetary benefits of a vaccine that the ENTIRE WORLD POPULATION is demanding. Jonas Salk provided his Polio vaccine free of charge 65 years ago, do we cynics think that will be the case this time around?

I think that depends on who ends up developing it. Bill Gates seems to be a leader in vaccine funding  and his life goal is to give half his fortune away, so if he funds a winner and builds its infrastructure for manufacturing, it should at least be free to developing nations.

Nobel Prize for Medicine, anyone?
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 09:02:45 AM
I don't quite understand the optimism about this vaccine. We still don't have a vaccine for SARs, that this is most similar to.....
Compared to a Covid-19 vaccine, do you think 1/1000th the resources are being devoted to a SARS vaccine? I'd be quite surprised if yesterday alone more money wasn't spent developing a Covid-19 vaccine than was ever spent on a SARS vaccine.

I don’t think there’s a linear relationship between vaccine development and money allocated.  By which I mean spending 1000x doesn’t get you a vaccine 1000x faster.  Sure, throwing more resources at a disease certainly helps, but the complexity remains.  There’s no certainty that an effective vaccine will be developed and readily available by next year, or even the following year.

They are going to start DOZENS of Covid19 Vaccine trials in the next couple months. Forget the humanitarian aspects and prestige aspects of developing a safe and effective vaccine. Imagine the monetary benefits of a vaccine that the ENTIRE WORLD POPULATION is demanding. Jonas Salk provided his Polio vaccine free of charge 65 years ago, do we cynics think that will be the case this time around?

Given that there are a number of countries involved and collaborating to develop a vaccine who -by their own laws - provide their citizens with vaccines free of charge I think much of the world will get it for free if/when an effective vaccine can be synthesized in mass quantities.  The economic costs of NOT vaccinating your workforce far outstrip paying even several hundred dollars per vaccine.

What's an interesting question to me is whether the United States will cow to the insurance companies and 'Big Pharma' and try to monetize a future vaccine.  The ACA required a number of "essential" vaccines to be covered, but the GOP has been hacking at the knees for years.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on April 10, 2020, 09:07:28 AM
I’ve been tracking the case and death numbers in Spain, Italy, NY/NJ, etc and they all follow a similar pattern in terms of a rapid increase in deaths per day, then a plateau. Italy is still having about 600-800 deaths a day with only a small sign of a drop after 2 weeks. It is not a symmetric peak by any means, more of a sharp uptick and a slow taper down

That plateau is a result of the stringent lockdown. It doesnt just happen. Without it, you would continue to see the rapid increase.

I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.

You're right.  The big question for me is that tension between lockdown and the larger economy.  How long can a lockdown be sustained without doing such damage to the economy that it becomes a bigger issue than the pandemic? How long before you have a rebellion against that lockdown?

There is a trite and fundamentally untrue adage that "if it saves lives it's worth it!"  That's not true.  Lives don't have infinite economic value. We implicitly make cost vs lives tradeoffs all the time. The other day I saw a somewhat snarky but telling comparison of the many of people have been unemployed as a result of the lockdowns for each life lost in the US due to the virus. It was quite a high number.     
Title: Re: How long can we wait while flattening the curve?
Post by: GuitarStv on April 10, 2020, 09:28:28 AM
I don't quite understand the optimism about this vaccine. We still don't have a vaccine for SARs, that this is most similar to.....
Compared to a Covid-19 vaccine, do you think 1/1000th the resources are being devoted to a SARS vaccine? I'd be quite surprised if yesterday alone more money wasn't spent developing a Covid-19 vaccine than was ever spent on a SARS vaccine.

I don’t think there’s a linear relationship between vaccine development and money allocated.  By which I mean spending 1000x doesn’t get you a vaccine 1000x faster.  Sure, throwing more resources at a disease certainly helps, but the complexity remains.  There’s no certainty that an effective vaccine will be developed and readily available by next year, or even the following year.

They are going to start DOZENS of Covid19 Vaccine trials in the next couple months. Forget the humanitarian aspects and prestige aspects of developing a safe and effective vaccine. Imagine the monetary benefits of a vaccine that the ENTIRE WORLD POPULATION is demanding. Jonas Salk provided his Polio vaccine free of charge 65 years ago, do we cynics think that will be the case this time around?

Given that there are a number of countries involved and collaborating to develop a vaccine who -by their own laws - provide their citizens with vaccines free of charge I think much of the world will get it for free if/when an effective vaccine can be synthesized in mass quantities.  The economic costs of NOT vaccinating your workforce far outstrip paying even several hundred dollars per vaccine.

What's an interesting question to me is whether the United States will cow to the insurance companies and 'Big Pharma' and try to monetize a future vaccine.  The ACA required a number of "essential" vaccines to be covered, but the GOP has been hacking at the knees for years.

Capitalism is the divine path, and paying for health care is a holy sacrament in the US.  You wouldn't want to become Godless socialists and give up worship of the almighty dollar, would you?
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 09:41:37 AM
I’ve been tracking the case and death numbers in Spain, Italy, NY/NJ, etc and they all follow a similar pattern in terms of a rapid increase in deaths per day, then a plateau. Italy is still having about 600-800 deaths a day with only a small sign of a drop after 2 weeks. It is not a symmetric peak by any means, more of a sharp uptick and a slow taper down

That plateau is a result of the stringent lockdown. It doesnt just happen. Without it, you would continue to see the rapid increase.

I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.

You're right.  The big question for me is that tension between lockdown and the larger economy.  How long can a lockdown be sustained without doing such damage to the economy that it becomes a bigger issue than the pandemic? How long before you have a rebellion against that lockdown?

There is a trite and fundamentally untrue adage that "if it saves lives it's worth it!"  That's not true.  Lives don't have infinite economic value. We implicitly make cost vs lives tradeoffs all the time. The other day I saw a somewhat snarky but telling comparison of the many of people have been unemployed as a result of the lockdowns for each life lost in the US due to the virus. It was quite a high number.     

This still makes the assumption that continuing a lock-down is more costly (in a strict financial sense) than opening up the economy prematurely.  Lives may not have infinite economic value to a society, but they do have a very high amount.  We know reasonably well what medical care costs per person per day for various scenarios (e.g. ICU vs simple doctor's visits) but there are real costs beyond that too... lost skills and cost of replacement, the financial burden on a family who's primary breadwinner dies (covered at least in part by SS and life insurance, but also social programs).  Then there's the much harder to predict effects of market forces on a business which are traced back to an outbreak - how do you convince customers to come back into your store then?

Some historical analyses have shown that the cities and states which had the most strict and long lasting stay-at-home orders had a lower financial toll than those who allowed businesses to remain open
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 09:43:47 AM

Capitalism is the divine path, and paying for health care is a holy sacrament in the US.  You wouldn't want to become Godless socialists and give up worship of the almighty dollar, would you?

Something like that.  After all you get health insurance only if you are employed as a full-time employee, or a senior citizen.  Those who don't work are 'freeloaders' on the system, a moral failing on their part. If we changed that model what incentive would people have to remain tied to one employer? 
/sarcasm (but how many here actually think).
Title: Re: How long can we wait while flattening the curve?
Post by: JGS1980 on April 10, 2020, 09:48:50 AM
Some great points Nereo,

I think it may all depend on who wins the Vaccine race. If it's a private equity or sovereign wealth fund backed international pharmaceutical consortium -> we will all get hosed.

If it's European style socialist endeavor then things will cost a lot less.

That being said, I'm not so sure the US system won't still find a way to charge us $200 to administer each $5 vaccine.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on April 10, 2020, 09:55:59 AM

Capitalism is the divine path, and paying for health care is a holy sacrament in the US.  You wouldn't want to become Godless socialists and give up worship of the almighty dollar, would you?

We in the US are already largely under a single payer system. Those over 65 are covered by medicare. Then there’s Medicaid for the poor. There’s CHIP for those under 18 who have low income but don’t qualify for Medicaid. Then there are the ACA exchanges. And those who work for state, local, and federal governments are covered under those plans.

I’m not a fan of single payer. Mostly because I think it’s just another shift of expenses from larger companies to the backs of taxpayers. But I think the argument that we shouldn’t or don’t have a single payer system is a silly one at this point. We’re already largely there and might as well try to wring some of the benefits out of it.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 10:28:53 AM
That being said, I'm not so sure the US system won't still find a way to charge us $200 to administer each $5 vaccine.

We do seem to have a knack for making the same treatments, medicines and vaccines cost more here in our healthcare system.  Pay more!  Get Less!  Be perpetually uncertain about future coverage and costs!
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 10, 2020, 11:24:28 AM
I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.

The probable outcome from my perspective is that we have a harsh lockdown for another 1-2 months until the "hotspots" are under control, then a gradual, controlled loosening.  Once the virus is at relatively low levels we don't need to reduce transmission to zero, but we do still need to keep it low enough that the total number of cases continues to decline.

What does this look like? 

Probably some businesses reopening, but with reduced occupancy and/or other rules in place to reduce transmission risk.  Low risk transmission spots will reopen - things like golf courses, hiking spots, etc - places where people can safely stay spread out.  Things that pack a lot of people into a small space like theaters, concerts, and sporting events will stay closed for a while if we have any sense at all(and even if they're open, a lot of people won't be going there until this whole thing settles down)

And this all still requires a lot more testing and contact tracing than we're doing right now.  Making this work requires that we identify cases and quarantine them and people they've had contact with until we're sure they're negative for the virus.  "If you feel even slightly sick, stay the F home" needs to be the expectation until we have a vaccine.

Largely agree with this, and I know I'm in the minority, but we need to open up sporting events, concerts, etc. in July and August if the data continues the way it is.

You cannot be so scared of this virus that you just shut it down. That's a stupid plan. Allow people to exercise judgment. Simple guidelines:

-Stay home if you are above 65 or immunocompromised
-Take your temperature before attending the event
-Mask required to enter stadium
-Whatever else.

We cannot live in shutdown permanently.
Title: Re: How long can we wait while flattening the curve?
Post by: dandarc on April 10, 2020, 11:29:11 AM
Contingent on adequate testing / monitoring to quash the inevitable hot spots quickly, sure.

Apparently my local area is not projecting "peak COVID" until June. So we probably get to do the "only leave house for groceries" thing for a while.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 11:36:34 AM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.
FWIW my city just canceled the 17 day music festival that's held each year in July and brings in several hundred thousand tourists.
Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on April 10, 2020, 11:46:03 AM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.

disagree here. these are money multipliers. you buy gas. you buy more expensive food. pay for parking. go out to a restaurant afterwards. money flows and then the cycle resumes.

i'm sure there are calculations somewhere already to show the most effective forms of money multipliers (or whatever the appropriate term is). i'm sure capital improvement projects are near the top.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 11:53:25 AM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.

disagree here. these are money multipliers. you buy gas. you buy more expensive food. pay for parking. go out to a restaurant afterwards. money flows and then the cycle resumes.

i'm sure there are calculations somewhere already to show the most effective forms of money multipliers (or whatever the appropriate term is). i'm sure capital improvement projects are near the top.

Huh?  How is a sporting event a capital improvement project? 
To rephrase, IMO reopening most businesses (e.g. manufacturing, retail) seems like a higher priority and carries a significantly lower risk of setting off a massive local outbreak than cramming several thousand people together to watch a ball game.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 10, 2020, 11:54:31 AM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.
FWIW my city just canceled the 17 day music festival that's held each year in July and brings in several hundred thousand tourists.

I'll take my area of biggest fandom -- college football -- as an example.  At just Ohio State, there are 7/8 home games of 105,000 fans, plus many others who just come to be in the atmosphere. The bars, restaurants, hotels, shops, all of them make their living on these weekends. It really is the equivalent of destination towns losing their tourist season. The economic impact would be catastrophic.

The direct impact to the university would be massive.  Football games employ hundreds, if not thousands, of people.  Football ticket revenue alone brings in $50-60M per year, and the TV rights bring in another $30-40M.  This money, in turn, funds all of the other athletic sports (aside from men's basketball) combined.  You are talking thousands of scholarship athletes who have worked their entire life for this having it ripped away. And no, they could not operate without football, because football pays for all of this.

Aside from that, it would be the sign that we have started to flip the page.  Seeing full stadiums would be a huge mental boost to everyone.

Now, Ohio State has the benefit of being in Columbus.  But there are little college towns everywhere -- Auburn, Bloomington, State College, Norman, etc. -- that would have absolute economic devastation without football season.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 10, 2020, 11:56:06 AM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.

disagree here. these are money multipliers. you buy gas. you buy more expensive food. pay for parking. go out to a restaurant afterwards. money flows and then the cycle resumes.

i'm sure there are calculations somewhere already to show the most effective forms of money multipliers (or whatever the appropriate term is). i'm sure capital improvement projects are near the top.

Huh?  How is a sporting event a capital improvement project? 
To rephrase, IMO reopening most businesses (e.g. manufacturing, retail) seems like a higher priority and carries a significantly lower risk of setting off a massive local outbreak than cramming several thousand people together to watch a ball game.

We have to get smarter. We have to test more. We have to track more. We have to do better. A shutdown is not a long term solution.
Title: Re: How long can we wait while flattening the curve?
Post by: Davnasty on April 10, 2020, 11:57:44 AM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.
FWIW my city just canceled the 17 day music festival that's held each year in July and brings in several hundred thousand tourists.

Yes, these events are far from essential and much more dangerous in a pandemic than offices, retail, and restaurants.

Lots of people crowded into big open spaces, amenities like bathrooms and handrails in near constant use, people traveling from all over to attend events and potentially take the virus back home, Shouting, singing, drinking. There's just so many ways to transmit a virus in those conditions.

There's a reason events were being canceled first and they should be the last thing to reopen.

Perhaps sporting events could gradually open up with limited or no live spectators? I don't know enough about the economics of sporting events to know if that would be worthwhile but I think packed stadiums are a long ways away.
Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on April 10, 2020, 12:06:57 PM
Huh?  How is a sporting event a capital improvement project? 
sorry. i didn't mean to imply they were in the same category, but i understand how you reached that conclusion. i was just pointing out that cap improvement would likely be near the top of the list. i'm not sure where sporting events fall, but i suspect it's not low.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 12:07:47 PM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.
FWIW my city just canceled the 17 day music festival that's held each year in July and brings in several hundred thousand tourists.

I'll take my area of biggest fandom -- college football -- as an example.  At just Ohio State, there are 7/8 home games of 105,000 fans, plus many others who just come to be in the atmosphere. The bars, restaurants, hotels, shops, all of them make their living on these weekends. It really is the equivalent of destination towns losing their tourist season. The economic impact would be catastrophic.

The direct impact to the university would be massive.  Football games employ hundreds, if not thousands, of people.  Football ticket revenue alone brings in $50-60M per year, and the TV rights bring in another $30-40M.  This money, in turn, funds all of the other athletic sports (aside from men's basketball) combined.  You are talking thousands of scholarship athletes who have worked their entire life for this having it ripped away. And no, they could not operate without football, because football pays for all of this.

Aside from that, it would be the sign that we have started to flip the page.  Seeing full stadiums would be a huge mental boost to everyone.

Now, Ohio State has the benefit of being in Columbus.  But there are little college towns everywhere -- Auburn, Bloomington, State College, Norman, etc. -- that would have absolute economic devastation without football season.

I understand the economic impacts of large sporting events, and particularly how much revenue it can bring into a college town.  I was a scholarship athlete myself.  What I'm questioning is the assertion that we put such gatherings *ahead* of all the other things mentioned... restaurants and hotels and shops.

Frankly, if our values are to prioritize getting a bunch of people huddled together to watch an entertaining but ultimately frivolous game, than we truly have lost sight of far more important things.  Plenty of towns all over the world are dependent on one or two businesses - if a local economy is overwhelmingly dependent on college games it wasn't very robust to begin with. 
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 10, 2020, 12:16:37 PM
Yes, these events are far from essential and much more dangerous in a pandemic than offices, retail, and restaurants.

Frankly, if our values are to prioritize getting a bunch of people huddled together to watch an entertaining but ultimately frivolous game, than we truly have lost sight of far more important things.  Plenty of towns all over the world are dependent on one or two businesses - if a local economy is overwhelmingly dependent on college games it wasn't very robust to begin with. 

The common thread here is that it's not your lives on the line, so it's non-essential, or a non-priority, to you. Who cares if there's no football? It presumably has no effect on you, so you don't care.

But we are talking millions of people here who will go bankrupt and lose everything if we don't open these things up soon. The public health consequences from that are dire. Are they worse than a possible outbreak? I don't know, I don't have enough data on that. But I know for a fact the public health consequences of rendering entire swaths of the United States as "non-essential" for too long will have catastrophic consequences.

We cannot ignore these while we bow at the alter of possible outbreaks interminably. At some point we have to put better protocols, testing, etc. in place and let people make their own decisions.
Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on April 10, 2020, 12:27:52 PM
Plenty of towns all over the world are dependent on one or two businesses - if a local economy is overwhelmingly dependent on college games it wasn't very robust to begin with.

sorry. this argument doesn't hold water. every town/city economy in the world depends on the interactions of the current economic interaction. it's how it's evolved. to carve out some things (sporting events, for example) as unnecessary is a slippery slope with immense ripple effects.
pedicures?
hair salons?
yoga?
a gym?
should we have pets and pet stores?
etc etc.

i'm in seattle. highly highly diversified economy and home to some of the biggest companies in the world. seattle will crumble to the ground if we maintain current shutdown levels for too long. all places will.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 10, 2020, 12:35:30 PM
i'm in seattle. highly highly diversified economy and home to some of the biggest companies in the world. seattle will crumble to the ground if we maintain current shutdown levels for too long. all places will.

This is my larger point.  The lockdown/social distancing was never to defeat the virus. That's impossible. It was to slow the spread so we could increase capacity, improve testing, improve tracking, etc.

We are getting there. We've dramatically increased capacity and production of PPE.  Perhaps more importantly, Nate Silver has noticed an interesting trend: https://twitter.com/NateSilver538/status/1248643693684367360?s=20

Basically, while the virus is highly contagious, our expected hospitalization rate might be lower than we thought.  That's excellent news if that data point holds true.  It means that our worst fear -- hospitals getting crushed -- might be overblown, especially as the virus fades with summer.

So, we are on the way to achieving the goal. We've slowed the spread. We knew this would cause huge economic disruption, but we thought the short term tradeoff was worth it.

But then what? We simply have to reopen sooner or later. Whole towns and communities will turn into ghost towns if we don't do something.
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 12:52:29 PM

This is my larger point.  The lockdown/social distancing was never to defeat the virus. That's impossible. It was to slow the spread so we could increase capacity, improve testing, improve tracking, etc.

We are getting there. We've dramatically increased capacity and production of PPE.  Perhaps more importantly, Nate Silver has noticed an interesting trend: https://twitter.com/NateSilver538/status/1248643693684367360?s=20

Basically, while the virus is highly contagious, our expected hospitalization rate might be lower than we thought.  That's excellent news if that data point holds true.  It means that our worst fear -- hospitals getting crushed -- might be overblown, especially as the virus fades with summer.

So, we are on the way to achieving the goal. We've slowed the spread. We knew this would cause huge economic disruption, but we thought the short term tradeoff was worth it.

But then what? We simply have to reopen sooner or later. Whole towns and communities will turn into ghost towns if we don't do something.

I'm not disagreeing with you about needing an endgame - but its important to acknowledge that widespread community transmission may also create what we are all trying to prevent - widespread and deep economic pain, with whole towns and communities turning into ghost towns.

Open too soon and that's what we are likley to get.  Open to late and that's what we are likely to get. 

Also - above you mentioned the virus fading with summer.  Is that simply a function of time and more effective measures, or hope that warmer weather will reduce spread?  FWIW THe National ACademy of Sciences came out with some models refuting the oft-repeated idea that warmer weather will slow the spread. 
https://www.nap.edu/catalog/25771/rapid-expert-consultation-on-sars-cov-2-survival-in-relation-to-temperature-and-humidity-and-potential-for-seasonality-for-the-covid-19-pandemic-april-7-2020 (https://www.nap.edu/catalog/25771/rapid-expert-consultation-on-sars-cov-2-survival-in-relation-to-temperature-and-humidity-and-potential-for-seasonality-for-the-covid-19-pandemic-april-7-2020)
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on April 10, 2020, 12:52:33 PM

Largely agree with this, and I know I'm in the minority, but we need to open up sporting events, concerts, etc. in July and August if the data continues the way it is.

You cannot be so scared of this virus that you just shut it down. That's a stupid plan. Allow people to exercise judgment. Simple guidelines:

-Stay home if you are above 65 or immunocompromised
-Take your temperature before attending the event
-Mask required to enter stadium
-Whatever else.

We cannot live in shutdown permanently.

You may not be in the minority. I was a big proponent of a hard shut down early on and still am. However at some point, and I think it’s relatively soon, the “cure” becomes worse than the disease. The economic impacts of the shutdown will kill people as well.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 10, 2020, 01:02:17 PM

This is my larger point.  The lockdown/social distancing was never to defeat the virus. That's impossible. It was to slow the spread so we could increase capacity, improve testing, improve tracking, etc.

We are getting there. We've dramatically increased capacity and production of PPE.  Perhaps more importantly, Nate Silver has noticed an interesting trend: https://twitter.com/NateSilver538/status/1248643693684367360?s=20

Basically, while the virus is highly contagious, our expected hospitalization rate might be lower than we thought.  That's excellent news if that data point holds true.  It means that our worst fear -- hospitals getting crushed -- might be overblown, especially as the virus fades with summer.

So, we are on the way to achieving the goal. We've slowed the spread. We knew this would cause huge economic disruption, but we thought the short term tradeoff was worth it.

But then what? We simply have to reopen sooner or later. Whole towns and communities will turn into ghost towns if we don't do something.

I'm not disagreeing with you about needing an endgame - but its important to acknowledge that widespread community transmission may also create what we are all trying to prevent - widespread and deep economic pain, with whole towns and communities turning into ghost towns.

Open too soon and that's what we are likley to get.  Open to late and that's what we are likely to get. 

Also - above you mentioned the virus fading with summer.  Is that simply a function of time and more effective measures, or hope that warmer weather will reduce spread?  FWIW THe National ACademy of Sciences came out with some models refuting the oft-repeated idea that warmer weather will slow the spread. 
https://www.nap.edu/catalog/25771/rapid-expert-consultation-on-sars-cov-2-survival-in-relation-to-temperature-and-humidity-and-potential-for-seasonality-for-the-covid-19-pandemic-april-7-2020 (https://www.nap.edu/catalog/25771/rapid-expert-consultation-on-sars-cov-2-survival-in-relation-to-temperature-and-humidity-and-potential-for-seasonality-for-the-covid-19-pandemic-april-7-2020)

I can't find the link but I saw earlier this week that 97% of COVID-19 cases were within a certain longitudinal range.  The climates that are far warmer had reduced spread.

Will the virus go away in summer? No. But will not be as contagious.  That's what I read. And if this is true, then widespread community transmission is a much lesser risk.
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on April 10, 2020, 01:03:01 PM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.
FWIW my city just canceled the 17 day music festival that's held each year in July and brings in several hundred thousand tourists.

Yes, these events are far from essential and much more dangerous in a pandemic than offices, retail, and restaurants.

Lots of people crowded into big open spaces, amenities like bathrooms and handrails in near constant use, people traveling from all over to attend events and potentially take the virus back home, Shouting, singing, drinking. There's just so many ways to transmit a virus in those conditions.

There's a reason events were being canceled first and they should be the last thing to reopen.

Perhaps sporting events could gradually open up with limited or no live spectators? I don't know enough about the economics of sporting events to know if that would be worthwhile but I think packed stadiums are a long ways away.

Oh lord, yes. Imagine 107,000 people crammed shoulder-to-shoulder into Michigan Stadium in Ann Arbor for a late August football game. Plus the packed buses to and from parking sites, all the tailgating and frat parties and packed bars and restaurants in town all weekend...

I don't know what the answer is, but my own volunteer orgs are already cancelling much smaller fundraising events into the summer. It sucks.
Title: Re: How long can we wait while flattening the curve?
Post by: Davnasty on April 10, 2020, 01:11:00 PM
Yes, these events are far from essential and much more dangerous in a pandemic than offices, retail, and restaurants.

Frankly, if our values are to prioritize getting a bunch of people huddled together to watch an entertaining but ultimately frivolous game, than we truly have lost sight of far more important things.  Plenty of towns all over the world are dependent on one or two businesses - if a local economy is overwhelmingly dependent on college games it wasn't very robust to begin with. 

The common thread here is that it's not your lives on the line, so it's non-essential, or a non-priority, to you. Who cares if there's no football? It presumably has no effect on you, so you don't care.

But we are talking millions of people here who will go bankrupt and lose everything if we don't open these things up soon. The public health consequences from that are dire. Are they worse than a possible outbreak? I don't know, I don't have enough data on that. But I know for a fact the public health consequences of rendering entire swaths of the United States as "non-essential" for too long will have catastrophic consequences.

We cannot ignore these while we bow at the alter of possible outbreaks interminably. At some point we have to put better protocols, testing, etc. in place and let people make their own decisions.

I'm not saying that it's not a big deal or that I don't care, but on the spectrum of essential to non-essential, entertainment falls on the far end of non-essential. That's not my opinion, it's the definition. I agree that economic impacts should factor into decisions. I also agree that improved testing and protocols should be a priority. Once we know where the virus is and where it isn't, we can start making better decisions.

My main point was that large events with people moving around in close proximity risks spreading the virus in ways that other businesses do not. A single event could reignite the pandemic and undo weeks of shutdown efforts.

Here's a good article on virus transmission dynamics. Risk doesn't just grow with crowd size, it compounds.

https://www.nationalgeographic.com/science/2020/03/what-is-safest-gathering-size-coronavirus-wrong-question/
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on April 10, 2020, 01:13:56 PM

The common thread here is that it's not your lives on the line, so it's non-essential, or a non-priority, to you. Who cares if there's no football? It presumably has no effect on you, so you don't care.

But we are talking millions of people here who will go bankrupt and lose everything if we don't open these things up soon. The public health consequences from that are dire. Are they worse than a possible outbreak? I don't know, I don't have enough data on that. But I know for a fact the public health consequences of rendering entire swaths of the United States as "non-essential" for too long will have catastrophic consequences.

We cannot ignore these while we bow at the alter of possible outbreaks interminably. At some point we have to put better protocols, testing, etc. in place and let people make their own decisions.

Here! Here!

And we’re not even talking about the impact on people outside the US. Look, I’m no fan of globalization. But the reality is we are where we are and a helluva a lot of people outside the US are indirectly dependent on the US economy for “frivolous” luxuries like eating.  Keeping our economy shut down means other people die. If we’re really in this for the “greater good” then we’ll be looking very keenly at the economic impacts as well. Not just making sure that folks in the first world have enough available ventilators. It’s really easy to talk about noble things like sacrifice when you have a full belly.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 10, 2020, 01:14:23 PM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.
FWIW my city just canceled the 17 day music festival that's held each year in July and brings in several hundred thousand tourists.

Yes, these events are far from essential and much more dangerous in a pandemic than offices, retail, and restaurants.

Lots of people crowded into big open spaces, amenities like bathrooms and handrails in near constant use, people traveling from all over to attend events and potentially take the virus back home, Shouting, singing, drinking. There's just so many ways to transmit a virus in those conditions.

There's a reason events were being canceled first and they should be the last thing to reopen.

Perhaps sporting events could gradually open up with limited or no live spectators? I don't know enough about the economics of sporting events to know if that would be worthwhile but I think packed stadiums are a long ways away.

Oh lord, yes. Imagine 107,000 people crammed shoulder-to-shoulder into Michigan Stadium in Ann Arbor for a late August football game. Plus the packed buses to and from parking sites, all the tailgating and frat parties and packed bars and restaurants in town all weekend...

I don't know what the answer is, but my own volunteer orgs are already cancelling much smaller fundraising events into the summer. It sucks.

How do you bring up Michigan.

(Go Bucks.)
Title: Re: How long can we wait while flattening the curve?
Post by: nereo on April 10, 2020, 01:24:52 PM

This is my larger point.  The lockdown/social distancing was never to defeat the virus. That's impossible. It was to slow the spread so we could increase capacity, improve testing, improve tracking, etc.

We are getting there. We've dramatically increased capacity and production of PPE.  Perhaps more importantly, Nate Silver has noticed an interesting trend: https://twitter.com/NateSilver538/status/1248643693684367360?s=20

Basically, while the virus is highly contagious, our expected hospitalization rate might be lower than we thought.  That's excellent news if that data point holds true.  It means that our worst fear -- hospitals getting crushed -- might be overblown, especially as the virus fades with summer.

So, we are on the way to achieving the goal. We've slowed the spread. We knew this would cause huge economic disruption, but we thought the short term tradeoff was worth it.

But then what? We simply have to reopen sooner or later. Whole towns and communities will turn into ghost towns if we don't do something.

I'm not disagreeing with you about needing an endgame - but its important to acknowledge that widespread community transmission may also create what we are all trying to prevent - widespread and deep economic pain, with whole towns and communities turning into ghost towns.

Open too soon and that's what we are likley to get.  Open to late and that's what we are likely to get. 

Also - above you mentioned the virus fading with summer.  Is that simply a function of time and more effective measures, or hope that warmer weather will reduce spread?  FWIW THe National ACademy of Sciences came out with some models refuting the oft-repeated idea that warmer weather will slow the spread. 
https://www.nap.edu/catalog/25771/rapid-expert-consultation-on-sars-cov-2-survival-in-relation-to-temperature-and-humidity-and-potential-for-seasonality-for-the-covid-19-pandemic-april-7-2020 (https://www.nap.edu/catalog/25771/rapid-expert-consultation-on-sars-cov-2-survival-in-relation-to-temperature-and-humidity-and-potential-for-seasonality-for-the-covid-19-pandemic-april-7-2020)

I can't find the link but I saw earlier this week that 97% of COVID-19 cases were within a certain longitudinal range.  The climates that are far warmer had reduced spread.

Will the virus go away in summer? No. But will not be as contagious.  That's what I read. And if this is true, then widespread community transmission is a much lesser risk.

I've seen such claims made before. However, the latest data are far less optimistic about warming weather slowing the spread.  See article linked above, released three days ago.

My main point was that large events with people moving around in close proximity risks spreading the virus in ways that other businesses do not. A single event could reignite the pandemic and undo weeks of shutdown efforts.

Here's a good article on virus transmission dynamics. Risk doesn't just grow with crowd size, it compounds.

https://www.nationalgeographic.com/science/2020/03/what-is-safest-gathering-size-coronavirus-wrong-question/

Not only does it have the potential to reignite pandemics - major sporting events and other very large entertainment gatherings are the nexus of some of the worst outbreaks we are facing right now, such as in Italy,  where the outbreak has been traced back to a championship league match in Milan.

@ReadySetMillionaire - I'm not sure where you are getting that these things 'don't matter' to me. That's kind of a backhand way of suggesting my thoughts don't matter.  On the contrary, I'm very much looking forward to the day when we can once again have large sporting events, and sports has played a large role in mine and my family's lives.  But so long as we have numerous asymptomatic spreaders within the population and no effective and widespread capabilities of testing, and no real cure, gatherings of more than a few hundred people are incredibly risky both from a public health standpoint but also from a financial risk standpoint.  That in essence is what has already been concluded by leagues with input not just from WHO and the CDC but also economists and epidemologists.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 10, 2020, 02:07:47 PM
I'm not sure where you are getting that these things 'don't matter' to me. That's kind of a backhand way of suggesting my thoughts don't matter.  On the contrary, I'm very much looking forward to the day when we can once again have large sporting events, and sports has played a large role in mine and my family's lives.  But so long as we have numerous asymptomatic spreaders within the population and no effective and widespread capabilities of testing, and no real cure, gatherings of more than a few hundred people are incredibly risky both from a public health standpoint but also from a financial risk standpoint.  That in essence is what has already been concluded by leagues with input not just from WHO and the CDC but also economists and epidemologists.

I'm sorry for giving off the impression that I didn't think your thoughts mattered.  That wasn't my intention.  Sorry.

What I am saying is that the concept is just a little more abstract to you.  Sure, you may have played sports, but you do not own a business that depends on this type of stuff (sports, concerts, etc.) to stay afloat.  So it's a lot easier for you to say that we should not do this or do that -- it does not really affect you.
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on April 10, 2020, 02:52:04 PM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.
FWIW my city just canceled the 17 day music festival that's held each year in July and brings in several hundred thousand tourists.

Yes, these events are far from essential and much more dangerous in a pandemic than offices, retail, and restaurants.

Lots of people crowded into big open spaces, amenities like bathrooms and handrails in near constant use, people traveling from all over to attend events and potentially take the virus back home, Shouting, singing, drinking. There's just so many ways to transmit a virus in those conditions.

There's a reason events were being canceled first and they should be the last thing to reopen.

Perhaps sporting events could gradually open up with limited or no live spectators? I don't know enough about the economics of sporting events to know if that would be worthwhile but I think packed stadiums are a long ways away.

Oh lord, yes. Imagine 107,000 people crammed shoulder-to-shoulder into Michigan Stadium in Ann Arbor for a late August football game. Plus the packed buses to and from parking sites, all the tailgating and frat parties and packed bars and restaurants in town all weekend...

I don't know what the answer is, but my own volunteer orgs are already cancelling much smaller fundraising events into the summer. It sucks.

How do you bring up Michigan.

(Go Bucks.)

It's my alma mater. Go Blue.
Title: Re: How long can we wait while flattening the curve?
Post by: kenmoremmm on April 10, 2020, 02:54:54 PM
you both suck.
on wisconsin
Title: Re: How long can we wait while flattening the curve?
Post by: js82 on April 10, 2020, 03:04:18 PM
I know. My point is the lockdown will have to continue for a long time. There’s no easy way out of this.

The probable outcome from my perspective is that we have a harsh lockdown for another 1-2 months until the "hotspots" are under control, then a gradual, controlled loosening.  Once the virus is at relatively low levels we don't need to reduce transmission to zero, but we do still need to keep it low enough that the total number of cases continues to decline.

What does this look like? 

Probably some businesses reopening, but with reduced occupancy and/or other rules in place to reduce transmission risk.  Low risk transmission spots will reopen - things like golf courses, hiking spots, etc - places where people can safely stay spread out.  Things that pack a lot of people into a small space like theaters, concerts, and sporting events will stay closed for a while if we have any sense at all(and even if they're open, a lot of people won't be going there until this whole thing settles down)

And this all still requires a lot more testing and contact tracing than we're doing right now.  Making this work requires that we identify cases and quarantine them and people they've had contact with until we're sure they're negative for the virus.  "If you feel even slightly sick, stay the F home" needs to be the expectation until we have a vaccine.

Largely agree with this, and I know I'm in the minority, but we need to open up sporting events, concerts, etc. in July and August if the data continues the way it is.

You cannot be so scared of this virus that you just shut it down. That's a stupid plan. Allow people to exercise judgment. Simple guidelines:

-Stay home if you are above 65 or immunocompromised
-Take your temperature before attending the event
-Mask required to enter stadium
-Whatever else.

We cannot live in shutdown permanently.

I don't think I disagree with you that grossly on this, other than I think July is going to be too soon for a full-scale reopening when it comes to large events where one person can potentially infect numerous others(unless we see a dramatic reduction in contagiousness in the summer heat).  I personally won't be going to concerts or sporting events in that time frame, even if they are open.

I do think Septemberish is realistic - which would set us up to have things mostly open for fall NCAA sports/NFL/NBA/NHL next season.

The reality is that the "reopening" in whatever form it takes, needs to be a collaborative discussion between economic and public health experts that centers on the following:

-For a given activity, how much will it help us economically by opening it back up?
-For that same activity, how much risk does it present in terms of disease transmission?
-Are there ways of doing that activity that would give us a lot of the benefit, while still cutting transmission risks (requiring attendees to wear masks, alternate-spot seating, etc.)?

Given the above, we would progressively open up, starting with higher-impact, lower-risk actions and moving on from there.  This will probably look quite a bit different in smaller towns(where the intrinsic rate of disease transmission is lower due to reduced population density) than in larger cities.

If we could contact trace like China this would all get much easier and we could open up sooner, but unfortunately we're light-years behind them on that front.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 10, 2020, 06:40:06 PM
Nobody gave a fuck about SARS.  That's not completely true, some people did, but by and large nobody gave a fuck about SARS.  SARS was an abstract thing that happened to other people, in another country, on another continent, and to most people it was nothing more than a blip in the news and some clips of some asian people wearing masks.  Total world wide deaths ended up being 774, largely concentrated in a handful of countries.  That's the same amount of deaths that occur due to traffic fatalities in the USA on an average week.  I vaguely remember the SARS epidemic, but it really didn't affect my life at all, and I think that's true of almost the entire population.  If you had a low information diet you may have even been completely unaware of SARS at all. 

Coronavirus however now has the entire world's attention.  In terms of infections, deaths, and disruption to people's lives the coronavirus is many, many orders of magnitude larger. We have more cases and deaths from coronavirus just in the metro detroit region than SARS had worldwide, and the pandemic is still raging on while we haven't had a single SARS case since 2003. I can't believe the resources being poured into SARS were even remotely comparable to the resources being poured into the coronavirus.  The entire species is focussing like a laser on the coronavirus, and if a vaccine is possible it will surely be developed, and in record time too.  Multiple trials have already started.  We are witnessing history in the making both in terms of the pandemic, and of what we as a species are capable of accomplishing.

SARS was a massive deal in those countries impacted, the same ones now dealing with covid well. There were actually huge resources put into controlling the outbreak and it absolutely changed people's lives. I have a surgeon in my area of the hospital who was in Hong Kong at the time of the SARS outbreak. He saw friends and colleagues get sick and die. For every single outbreak since, H1N1 or anything at all, he has put the entire staff on full PPE from the moment he heard about it. I'm admin, and I'm talking face masks, eye protection, stringent handwashing, staggered lunch breaks to avoid people contact, washing down of equipment etc. It's been a pain in the arse over the years but I don't think anyone will be complaining now! That's why there have been no more SARs outbreaks. That's why those asian countries have managed covid well. There have also been serious resources put into a SARs vaccine - which we still don't have. We actually don't have vaccines for any human corona viruses, including the common cold. Want to guess how much effort has been put into developing that one?
Title: Re: How long can we wait while flattening the curve?
Post by: former player on April 11, 2020, 02:50:50 AM
I had tickets for concerts in June and July this year that have been postponed to the same dates next year.  No way am I going to be standing in a crowd of 10 or 20 thousand people next summer unless I've had a coronavirus vaccine first.
Title: Re: How long can we wait while flattening the curve?
Post by: T-Money$ on April 11, 2020, 04:50:01 AM
It's worthwhile to spend some time looking back a few pages in this thread (1-3 weeks past).  A lot of the predictions about hospitalizations and death are wildly inaccurate.  Cuomo and deBlasio just last week were saying New York City would run out of ventilators and hospital beds.  Nothing can be further from the truth.

https://www.bloomberg.com/graphics/2020-new-york-coronavirus-outbreak-how-many-hospital-beds/

New York is currently using about 18,000 hospital beds for COVID-19 patients.  The estimated need at this point was 140,000.  Only a fraction of ventilators are being used, and the trend is for MD's to not use ventilators at all as there is little (if any) evidence they are an effective treatment for COVID-19.

https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Good data was released out of Germany this week, the iFR for the disease is 0.37%, which is about 10% of the initial WHO estimate of 3.8% earlier this year.  No wonder the statistical models were so horribly inaccurate. 

Mammograms, melanoma and pap smear screenings have halted and best case been delayed for months.  How many people will die from these diseases that are very treatable (but if not caught early are likely to be fatal)?

Alcoholism and substance abuse treatments (which are effective) have been halted.  How many people will die from these illnesses?

Poverty and economic decay are strongly associated with longevity.  How many of the newly impoverished will have their lives cut short?

The notion that shutting down the economy is not going to cause thousands (or more) to die is bizarre.  COVID-19 is truly only dangerous to a small subset of the population.  Shutting down the economy indiscriminately is criminal and likely not Constitutional. 

People have died regardless.  People will die regardless.  The idea that the infection can be reduced through social isolation is deeply misguided.  "Flattening the curve" (I cringe every time I read this nonsense) will not change the total outcome.  All that it will do is extend the situation which could have been resolved in a much shorter amount of time.

The virus will stop spreading once there is herd immunity.  Until then there is no effective treatment, there is no effective cure.  The consequences as a result of waiting for a vaccine (which is possible, but to date there has been no effective vaccine for any coronavirus) has caused the suffering of hundreds of millions (if not billions).

So yes, a very small percentage of humanity will die, to date that number is 0.0012%.

The hospitals are not overwhelmed.  They were never at risk of being overwhelmed and they never will be overwhelmed.  The only thing "flat curving" does is it theoretically had the potential to keep our health system functioning.  We are likely at virus peak or close to it in many metropolitan areas, so there is no reason to continue shelter in place or lockdowns.  Such behavior is foolishness, might as well start putting people in prison when they claim the Earth is round.

Regardless of what we do, regardless of what you do, herd immunity will be achieved whether you like it or not.  Probably well before a vaccine is widely administered. 



Title: Re: How long can we wait while flattening the curve?
Post by: Paper Chaser on April 11, 2020, 06:31:17 AM

And you completely missed my point. The odds of a young person seeing moderate symptoms are pretty darn low. They broadcast a handful of stories about them specifically because it's uncommon and newsworthy.

I don't think there's any question that the economy still would've been impacted by the virus without shutdowns. But what is in question is how severe that impact might've been. If a business owner loses a percentage of their employees and customers due to symptoms of being ill or fears of venturing into public, is that better than having the business essentially closed (or fully closed) by a mandated shutdown? Would a business rather stay open for the healthy 60% of its staff and 30-50% of it's normal revenue, or would they rather lay nearly everybody off, and have little or no revenue? Is some commerce better than no commerce for a small business?

Hmm... the data shows otherwise.  It's certainly true that the likelihood of a young person who's contracted the virus of dying are low (i.e. mortality rate), but a large portion still get moderate symptoms.  And with an illness like this one, 'moderate symptoms' are strong enough to curtail normal function for several days.

Can you share some of this data? I'm not talking about percentages of young people that see moderate symptoms after being confirmed to have COVID. It wouldn't surprise me to see that number being as high as 20-30% maybe. But we know that young people are less likely to have confirmed cases of COVID in the first place, and Outside of rare situations, we're still only testing those that already show symptoms, and many with few or no symptoms are not being tested. So it's very likely that we have a bunch of assymptomatic or mildly symptomatic people walking around that we just don't know about. The Diamond Princess cruise ship study showed around 50% of confirmed positive cases were assymptomatic, and that was with a test sample population that skewed older than average.

When I say the odds of a young person seeing moderate symptoms are low, I'm talking about the percentage of all the young people, not just those confirmed to have COVID right now. So if there are X million people in MI age 30-39, what percentage of those are going to see moderate symptoms? Very few are even showing enough symptoms to be tested at this point, let alone suffer moderate symptoms. I'd bet it's much lower than 1% of that demographic showing infection, and obviously not everyone confirmed infected sees moderate symptoms but 1% makes the math easier. So if 1% of 5 million have COVID, and 20% of those have moderate symptoms, you'd have 10k people in their 30s that would see moderate symptoms and miss a few days or weeks of work. And those situations would be spread out a bit over time too. That's much less of the workforce idled at a given time than what we're currently seeing.
Title: Re: How long can we wait while flattening the curve?
Post by: Buffaloski Boris on April 11, 2020, 06:38:25 AM
It's worthwhile to spend some time looking back a few pages in this thread (1-3 weeks past).  A lot of the predictions about hospitalizations and death are wildly inaccurate.  Cuomo and deBlasio just last week were saying New York City would run out of ventilators and hospital beds.  Nothing can be further from the truth.

https://www.bloomberg.com/graphics/2020-new-york-coronavirus-outbreak-how-many-hospital-beds/

New York is currently using about 18,000 hospital beds for COVID-19 patients.  The estimated need at this point was 140,000.  Only a fraction of ventilators are being used, and the trend is for MD's to not use ventilators at all as there is little (if any) evidence they are an effective treatment for COVID-19.

https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Good data was released out of Germany this week, the iFR for the disease is 0.37%, which is about 10% of the initial WHO estimate of 3.8% earlier this year.  No wonder the statistical models were so horribly inaccurate. 

Mammograms, melanoma and pap smear screenings have halted and best case been delayed for months.  How many people will die from these diseases that are very treatable (but if not caught early are likely to be fatal)?

Alcoholism and substance abuse treatments (which are effective) have been halted.  How many people will die from these illnesses?

Poverty and economic decay are strongly associated with longevity.  How many of the newly impoverished will have their lives cut short?

The notion that shutting down the economy is not going to cause thousands (or more) to die is bizarre.  COVID-19 is truly only dangerous to a small subset of the population.  Shutting down the economy indiscriminately is criminal and likely not Constitutional. 

People have died regardless.  People will die regardless.  The idea that the infection can be reduced through social isolation is deeply misguided.  "Flattening the curve" (I cringe every time I read this nonsense) will not change the total outcome.  All that it will do is extend the situation which could have been resolved in a much shorter amount of time.

The virus will stop spreading once there is herd immunity.  Until then there is no effective treatment, there is no effective cure.  The consequences as a result of waiting for a vaccine (which is possible, but to date there has been no effective vaccine for any coronavirus) has caused the suffering of hundreds of millions (if not billions).

So yes, a very small percentage of humanity will die, to date that number is 0.0012%.

The hospitals are not overwhelmed.  They were never at risk of being overwhelmed and they never will be overwhelmed.  The only thing "flat curving" does is it theoretically had the potential to keep our health system functioning.  We are likely at virus peak or close to it in many metropolitan areas, so there is no reason to continue shelter in place or lockdowns.  Such behavior is foolishness, might as well start putting people in prison when they claim the Earth is round.

Regardless of what we do, regardless of what you do, herd immunity will be achieved whether you like it or not.  Probably well before a vaccine is widely administered.

Thank you for your very interesting and enlightening post! 
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 11, 2020, 07:04:39 AM
It's worthwhile to spend some time looking back a few pages in this thread (1-3 weeks past).  A lot of the predictions about hospitalizations and death are wildly inaccurate.  Cuomo and deBlasio just last week were saying New York City would run out of ventilators and hospital beds.  Nothing can be further from the truth.

https://www.bloomberg.com/graphics/2020-new-york-coronavirus-outbreak-how-many-hospital-beds/

New York is currently using about 18,000 hospital beds for COVID-19 patients.  The estimated need at this point was 140,000.  Only a fraction of ventilators are being used, and the trend is for MD's to not use ventilators at all as there is little (if any) evidence they are an effective treatment for COVID-19.

https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Good data was released out of Germany this week, the iFR for the disease is 0.37%, which is about 10% of the initial WHO estimate of 3.8% earlier this year.  No wonder the statistical models were so horribly inaccurate. 

Mammograms, melanoma and pap smear screenings have halted and best case been delayed for months.  How many people will die from these diseases that are very treatable (but if not caught early are likely to be fatal)?

Alcoholism and substance abuse treatments (which are effective) have been halted.  How many people will die from these illnesses?

Poverty and economic decay are strongly associated with longevity.  How many of the newly impoverished will have their lives cut short?

The notion that shutting down the economy is not going to cause thousands (or more) to die is bizarre.  COVID-19 is truly only dangerous to a small subset of the population.  Shutting down the economy indiscriminately is criminal and likely not Constitutional. 

People have died regardless.  People will die regardless.  The idea that the infection can be reduced through social isolation is deeply misguided.  "Flattening the curve" (I cringe every time I read this nonsense) will not change the total outcome.  All that it will do is extend the situation which could have been resolved in a much shorter amount of time.

The virus will stop spreading once there is herd immunity.  Until then there is no effective treatment, there is no effective cure.  The consequences as a result of waiting for a vaccine (which is possible, but to date there has been no effective vaccine for any coronavirus) has caused the suffering of hundreds of millions (if not billions).

So yes, a very small percentage of humanity will die, to date that number is 0.0012%.

The hospitals are not overwhelmed.  They were never at risk of being overwhelmed and they never will be overwhelmed.  The only thing "flat curving" does is it theoretically had the potential to keep our health system functioning.  We are likely at virus peak or close to it in many metropolitan areas, so there is no reason to continue shelter in place or lockdowns.  Such behavior is foolishness, might as well start putting people in prison when they claim the Earth is round.

Regardless of what we do, regardless of what you do, herd immunity will be achieved whether you like it or not.  Probably well before a vaccine is widely administered.

It's hard to know where to start. You've not understood the purpose of social isolation. You don't grasp exactly what a virus peak is, or when/how it might occur. I'm not at all sure how you've decided that the hospitals are not overwhelmed, particularly in your neck of the woods. You don't know how a iFR is calculated, because if you did you wouldn't be quoting it as evidence of anything at all. Even if you meant CFR, that would also be meaningless applied to anywhere but Germany in early 2020....

And herd immunity.... let me tell you a little story about herd immunity that starts with a nasty little corona virus now known as the common cold, and ends with decimated colonised populations. I mean, sure, it sounds great as long as you're on the right side of it. What you haven't understood about herd immunity is that it doesn't happen in one epidemic or in one generation. Countless hundreds of thousands of people have died over a thousand years so that you now get to experience not much more than an annoying sniffle. You know what smallpox has been doing to humans for the last few hundred years, killing and disfiguring thousands and thousands of us EVERY summer in every part of the world before we developed a vaccine? That's right - it's been giving us herd immunity. Fun process, huh? Can you imagine covid flaring up every season for the next five hundred years? Sound unlikely? In human history this has happened thousands of times. Some stuff we assimilated, like the cold. Some stuff just disappeared, we have no idea why, like 'the sweat' of several hundred years ago. Some stuff got worse symptoms over time, not better, like measles. Some stuff is probably the reason why cities were abandoned. It cleared out whole populations. And some stuff doesn't give you immunity. We're not sure that's not the case with covid19. Herd immunity is something we have had no choice about in the past. Once you do have a choice, it's a spectacularly stupid idea to take on as a tactic against a virus.

I understand that this post will probably just go straight over your head, and you'll do the unsmart double-down in response. I won't be participating. Cheerio, and best of luck with that whole herd immunity thing. You appear to be in exactly the right locale to participate, just get on out there and breathe in as much used air as you can.
Title: Re: How long can we wait while flattening the curve?
Post by: kenner on April 11, 2020, 07:10:35 AM
It's worthwhile to spend some time looking back a few pages in this thread (1-3 weeks past).  A lot of the predictions about hospitalizations and death are wildly inaccurate.  Cuomo and deBlasio just last week were saying New York City would run out of ventilators and hospital beds.  Nothing can be further from the truth.

https://www.bloomberg.com/graphics/2020-new-york-coronavirus-outbreak-how-many-hospital-beds/

New York is currently using about 18,000 hospital beds for COVID-19 patients.  The estimated need at this point was 140,000.  Only a fraction of ventilators are being used, and the trend is for MD's to not use ventilators at all as there is little (if any) evidence they are an effective treatment for COVID-19.

https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Good data was released out of Germany this week, the iFR for the disease is 0.37%, which is about 10% of the initial WHO estimate of 3.8% earlier this year.  No wonder the statistical models were so horribly inaccurate. 

Mammograms, melanoma and pap smear screenings have halted and best case been delayed for months.  How many people will die from these diseases that are very treatable (but if not caught early are likely to be fatal)?

Alcoholism and substance abuse treatments (which are effective) have been halted.  How many people will die from these illnesses?

Poverty and economic decay are strongly associated with longevity.  How many of the newly impoverished will have their lives cut short?

The notion that shutting down the economy is not going to cause thousands (or more) to die is bizarre.  COVID-19 is truly only dangerous to a small subset of the population.  Shutting down the economy indiscriminately is criminal and likely not Constitutional. 

People have died regardless.  People will die regardless.  The idea that the infection can be reduced through social isolation is deeply misguided. "Flattening the curve" (I cringe every time I read this nonsense) will not change the total outcome.  All that it will do is extend the situation which could have been resolved in a much shorter amount of time.

The virus will stop spreading once there is herd immunity.  Until then there is no effective treatment, there is no effective cure.  The consequences as a result of waiting for a vaccine (which is possible, but to date there has been no effective vaccine for any coronavirus) has caused the suffering of hundreds of millions (if not billions).

So yes, a very small percentage of humanity will die, to date that number is 0.0012%.

The hospitals are not overwhelmed.  They were never at risk of being overwhelmed and they never will be overwhelmed.  The only thing "flat curving" does is it theoretically had the potential to keep our health system functioning.  We are likely at virus peak or close to it in many metropolitan areas, so there is no reason to continue shelter in place or lockdowns.  Such behavior is foolishness, might as well start putting people in prison when they claim the Earth is round.

Regardless of what we do, regardless of what you do, herd immunity will be achieved whether you like it or not.  Probably well before a vaccine is widely administered.

Thank you for your very interesting and enlightening post!

Bolding mine.  And right, it's not like there was nowhere on Earth where patients were literally lining hospital halls and doctors were having to pick who had even a chance at living.

Oh, wait.  That did happen.

Maybe those lives didn't matter because it didn't happen in the US?  Not to state the (completely) obvious, but the fact that it hasn't happened in the US is because of that 'flattening the curve' nonsense that makes you so cringe so much.

Sure, people are going to die 'regardless.'  Everyone is going to die 'regardless.'  It's highly unlikely that 'regardless' means dropping dead in the streets by the thousands without something pretty nasty backing it so maybe don't be so quick to write off Grandpa (or everyone else who does't fit your convenient demographic narrative, for that matter).

Sure, the world economies can't stay shut down forever, I haven't seen anyone saying otherwise, but your pretension that there was no reason for any of this...wow.
Title: Re: How long can we wait while flattening the curve?
Post by: ReadySetMillionaire on April 11, 2020, 07:16:39 AM
Bolding mine.  And right, it's not like there was nowhere on Earth where patients were literally lining hospital halls and doctors were having to pick who had even a chance at living.

Oh, wait.  That did happen.

Maybe those lives didn't matter because it didn't happen in the US?  Not to state the (completely) obvious, but the fact that it hasn't happened in the US is because of that 'flattening the curve' nonsense that makes you so cringe so much.

Sure, people are going to die 'regardless.'  Everyone is going to die 'regardless.'  It's highly unlikely that 'regardless' means dropping dead in the streets by the thousands without something pretty nasty backing it so maybe don't be so quick to write off Grandpa (or everyone else who does't fit your convenient demographic narrative, for that matter).

Sure, the world economies can't stay shut down forever, I haven't seen anyone saying otherwise, but your pretension that there was no reason for any of this...wow.

Italy made the biggest mistake out of any country on earth.  They elected to hospitalize almost all COVID-19 patients from the outset as a means to isolate them from the rest of the population.  Thus, when even a small surge came and seriously ill patients needed beds, they were not there.

We fortunately learned from Italy and have not come even close to making the same mistake.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 11, 2020, 07:22:30 AM
Bolding mine.  And right, it's not like there was nowhere on Earth where patients were literally lining hospital halls and doctors were having to pick who had even a chance at living.

Oh, wait.  That did happen.

Maybe those lives didn't matter because it didn't happen in the US?  Not to state the (completely) obvious, but the fact that it hasn't happened in the US is because of that 'flattening the curve' nonsense that makes you so cringe so much.

Sure, people are going to die 'regardless.'  Everyone is going to die 'regardless.'  It's highly unlikely that 'regardless' means dropping dead in the streets by the thousands without something pretty nasty backing it so maybe don't be so quick to write off Grandpa (or everyone else who does't fit your convenient demographic narrative, for that matter).

Sure, the world economies can't stay shut down forever, I haven't seen anyone saying otherwise, but your pretension that there was no reason for any of this...wow.

Italy made the biggest mistake out of any country on earth.  They elected to hospitalize almost all COVID-19 patients from the outset as a means to isolate them from the rest of the population.  Thus, when even a small surge came and seriously ill patients needed beds, they were not there.

We fortunately learned from Italy and have not come even close to making the same mistake.

Dude, you're surpassing Italy as we speak. And, honestly, your game has barely started.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 11, 2020, 07:23:05 AM
Look, we can either believe almost all epidemiologists and public health researchers in the developed world, or people who have no evidence on their side and frankly have been shown to be wrong by current data from CA and WA (neither of which have had a surge like NY/NJ/MI) Why are we still arguing this? Let’s agree to disagree on how many people we prefer to die from covid and how much economy we are willing to sacrifice.
Title: Re: How long can we wait while flattening the curve?
Post by: AnnaGrowsAMustache on April 11, 2020, 07:25:07 AM
It's worthwhile to spend some time looking back a few pages in this thread (1-3 weeks past).  A lot of the predictions about hospitalizations and death are wildly inaccurate.  Cuomo and deBlasio just last week were saying New York City would run out of ventilators and hospital beds.  Nothing can be further from the truth.

https://www.bloomberg.com/graphics/2020-new-york-coronavirus-outbreak-how-many-hospital-beds/

New York is currently using about 18,000 hospital beds for COVID-19 patients.  The estimated need at this point was 140,000.  Only a fraction of ventilators are being used, and the trend is for MD's to not use ventilators at all as there is little (if any) evidence they are an effective treatment for COVID-19.

https://www.statnews.com/2020/04/08/doctors-say-ventilators-overused-for-covid-19/

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Good data was released out of Germany this week, the iFR for the disease is 0.37%, which is about 10% of the initial WHO estimate of 3.8% earlier this year.  No wonder the statistical models were so horribly inaccurate. 

Mammograms, melanoma and pap smear screenings have halted and best case been delayed for months.  How many people will die from these diseases that are very treatable (but if not caught early are likely to be fatal)?

Alcoholism and substance abuse treatments (which are effective) have been halted.  How many people will die from these illnesses?

Poverty and economic decay are strongly associated with longevity.  How many of the newly impoverished will have their lives cut short?

The notion that shutting down the economy is not going to cause thousands (or more) to die is bizarre.  COVID-19 is truly only dangerous to a small subset of the population.  Shutting down the economy indiscriminately is criminal and likely not Constitutional. 

People have died regardless.  People will die regardless.  The idea that the infection can be reduced through social isolation is deeply misguided. "Flattening the curve" (I cringe every time I read this nonsense) will not change the total outcome.  All that it will do is extend the situation which could have been resolved in a much shorter amount of time.

The virus will stop spreading once there is herd immunity.  Until then there is no effective treatment, there is no effective cure.  The consequences as a result of waiting for a vaccine (which is possible, but to date there has been no effective vaccine for any coronavirus) has caused the suffering of hundreds of millions (if not billions).

So yes, a very small percentage of humanity will die, to date that number is 0.0012%.

The hospitals are not overwhelmed.  They were never at risk of being overwhelmed and they never will be overwhelmed.  The only thing "flat curving" does is it theoretically had the potential to keep our health system functioning.  We are likely at virus peak or close to it in many metropolitan areas, so there is no reason to continue shelter in place or lockdowns.  Such behavior is foolishness, might as well start putting people in prison when they claim the Earth is round.

Regardless of what we do, regardless of what you do, herd immunity will be achieved whether you like it or not.  Probably well before a vaccine is widely administered.

Thank you for your very interesting and enlightening post!

Bolding mine.  And right, it's not like there was nowhere on Earth where patients were literally lining hospital halls and doctors were having to pick who had even a chance at living.

Oh, wait.  That did happen.

Maybe those lives didn't matter because it didn't happen in the US?  Not to state the (completely) obvious, but the fact that it hasn't happened in the US is because of that 'flattening the curve' nonsense that makes you so cringe so much.

Sure, people are going to die 'regardless.'  Everyone is going to die 'regardless.'  It's highly unlikely that 'regardless' means dropping dead in the streets by the thousands without something pretty nasty backing it so maybe don't be so quick to write off Grandpa (or everyone else who does't fit your convenient demographic narrative, for that matter).

Sure, the world economies can't stay shut down forever, I haven't seen anyone saying otherwise, but your pretension that there was no reason for any of this...wow.

Don't even bother. The only curve the USA is showing signs of being great at flattening is the ECG.
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 11, 2020, 08:01:19 AM
The us is a big country. Washington and California have had relatively few deaths and no exponential uptick. Only 10% of people tested in my county in Southern California have been positive, so transmission here is quite low and the rate of new cases is relatively constant rather than increasing. Part of that is lower density than downtown LA or Especially NYC/NJ, but also all gatherings are shut down and parks, tourist sites closed.
Title: Re: How long can we wait while flattening the curve?
Post by: Sultan58 on April 11, 2020, 08:50:44 AM
Can you elaborate on why it's so important to open sporting events and concerts? 
I get that they are fun, but they also seem unessential in the grand scheme of what our economy needs to get the gears turning.
FWIW my city just canceled the 17 day music festival that's held each year in July and brings in several hundred thousand tourists.

I'll take my area of biggest fandom -- college football -- as an example.  At just Ohio State, there are 7/8 home games of 105,000 fans, plus many others who just come to be in the atmosphere. The bars, restaurants, hotels, shops, all of them make their living on these weekends. It really is the equivalent of destination towns losing their tourist season. The economic impact would be catastrophic.

The direct impact to the university would be massive.  Football games employ hundreds, if not thousands, of people.  Football ticket revenue alone brings in $50-60M per year, and the TV rights bring in another $30-40M.  This money, in turn, funds all of the other athletic sports (aside from men's basketball) combined.  You are talking thousands of scholarship athletes who have worked their entire life for this having it ripped away. And no, they could not operate without football, because football pays for all of this.

Aside from that, it would be the sign that we have started to flip the page.  Seeing full stadiums would be a huge mental boost to everyone.

Now, Ohio State has the benefit of being in Columbus.  But there are little college towns everywhere -- Auburn, Bloomington, State College, Norman, etc. -- that would have absolute economic devastation without football season.

geesh.....its a ball game.....its a concert.  All stuff we can live without for many more months. I take it you're in that business, so I see your point. But most of us could care less about attending mass gatherings in the next three months. That's a recipe for re-transmission and there's no way you can argue otherwise. What it IS exposing in college sports is the relentless and overdone emphasis on the revenue from those activities and the impact on the institutions of "higher learning",,,which is what they are supposed to be in the first place.
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on April 11, 2020, 10:31:07 AM
I don't have the mental energy to waste on extensive arguments today as I have to work, but the hospitals in my area are becoming overwhelmed. The convention center in downtown Detroit is now a 1000-bed FEMA field hospital that started accepting patients 2 days ago. Another local convention center is currently under conversion to a FEMA field hospital. Bodies are housed in refrigerated trucks because the morgues are full.

As per friends, patients are being treated and dying in hallways. Locally, we're very close to being out of PPE and various other supplies at medical centers, and hundreds of staff are testing positive for COVID-19.

And yes, I do know people with the virus. Currently, I'm hoping that two friends (mid-30s and early 40s, wealthy, active, healthy lifestyles) don't develop worse symptoms because I don't know who would care for their toddler. Also, my cousin lost a friend to it yesterday, and one of my friends lost an uncle. Spare me the "it doesn't exist or isn't really an issue" bullshit.
Title: Re: How long can we wait while flattening the curve?
Post by: the_fixer on April 11, 2020, 10:31:59 AM
The us is a big country. Washington and California have had relatively few deaths and no exponential uptick. Only 10% of people tested in my county in Southern California have been positive, so transmission here is quite low and the rate of new cases is relatively constant rather than increasing. Part of that is lower density than downtown LA or Especially NYC/NJ, but also all gatherings are shut down and parks, tourist sites closed.


What is not being considered is that most people can't identify a single person they know who even has the virus, much less died, and they will start to become deeply uncomfortable with being shut down while the statistics show that it is not required, and warm weather may be the last straw.  That is how the leaders will lose elections and that may be the only thing that moves them to act and open the     

I personally know 4 people that have tested positive for it 3 at work and one of my wife’s workout buddies.

2 have been hospitalized

Countless other at work that have been exposed and are under quarantine.


Sent from my iPhone using Tapatalk
Title: Re: How long can we wait while flattening the curve?
Post by: bacchi on April 11, 2020, 10:39:04 AM
L.A. County decided to extend the lockdown without evidence that it is required.

It looks like they reviewed the models. Do you have other evidence that they failed to review?

https://www.sgvtribune.com/2020/04/10/after-reviewing-growth-projections-la-county-extends-coronavirus-stay-home-orders/?from=groupmessage&isappinstalled=0

Quote
That is how the leaders will lose elections and that may be the only thing that moves them to act and open the economy. 

Maybe but, currently, America loves its governors:

https://fivethirtyeight.com/features/most-americans-like-how-their-governor-is-handling-the-coronavirus-outbreak/

In this poll, only DeSantis, who is all loosey-goosey on restrictions, has lost support.
Title: Re: How long can we wait while flattening the curve?
Post by: American GenX on April 11, 2020, 10:55:04 AM
I don't have the mental energy to waste on extensive arguments today as I have to work, but the hospitals in my area are becoming overwhelmed.

We're not overwhelmed yet in my area, but the state has only gotten a very small fraction of the PPE and ventilators from the federal government vs. what had been asked.  Outside of surgical mask, they had only received about 3% of what was requested, and we are no where near the peak.

Fortunately, the social distancing and stay-at-home orders are working to slow the spread, so we need to keep that up.  I shudder to think what would have happened without that.
Title: Re: How long can we wait while flattening the curve?
Post by: Laserjet3051 on April 11, 2020, 11:12:11 AM
Bolding mine.  And right, it's not like there was nowhere on Earth where patients were literally lining hospital halls and doctors were having to pick who had even a chance at living.

Oh, wait.  That did happen.

Maybe those lives didn't matter because it didn't happen in the US?  Not to state the (completely) obvious, but the fact that it hasn't happened in the US is because of that 'flattening the curve' nonsense that makes you so cringe so much.

Sure, people are going to die 'regardless.'  Everyone is going to die 'regardless.'  It's highly unlikely that 'regardless' means dropping dead in the streets by the thousands without something pretty nasty backing it so maybe don't be so quick to write off Grandpa (or everyone else who does't fit your convenient demographic narrative, for that matter).

Sure, the world economies can't stay shut down forever, I haven't seen anyone saying otherwise, but your pretension that there was no reason for any of this...wow.

Italy made the biggest mistake out of any country on earth.  They elected to hospitalize almost all COVID-19 patients from the outset as a means to isolate them from the rest of the population.  Thus, when even a small surge came and seriously ill patients needed beds, they were not there.

We fortunately learned from Italy and have not come even close to making the same mistake.

Dude, you're surpassing Italy as we speak. And, honestly, your game has barely started.

Please refrain from propagating misinformation ("game has barely started"). There are many current datasets in the USA that argue otherwise. 
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 11, 2020, 11:45:10 AM
I agree we can probably reopen rural areas once we have good evidence that the rate of infection in those areas is low. Even areas that have already had a surge, if there is a high rate of resolved sub clinical infection that means the risk of subsequent transmission is low. Until then, we don’t have much to go on. Hopefully those tests will be out soon.
Title: Re: How long can we wait while flattening the curve?
Post by: js82 on April 11, 2020, 12:08:41 PM
My appeal has been that customized solutions must be had across the country without influence or fear of criticism.  Your argument seems to be that it is so bad there that no one else can act based on their own region's situation as if opening the parks in a rural WA county would have any impact on NY or Detroit.  Critical thinking is lost, driven by fear.

Agree with the bolded part.  If we want to do this "the right way" I don't think you can force an identical ruleset on places with widely differing risk factors.  The problem is(relative to how we're currently running it), "the right way" largely doesn't even involve governors in anything other than a supporting role - it involves a task force of experts(including both public health and economic experts) at the federal level developing "best practice" guidelines that differentiate between the realities of denser and less-dense areas, and then the execution being driven at the local level based on the particulars on the ground in each area.

I still think it ends up being a measured, progressive deployment(as opposed to a "flip the switch" moment), but an optimized response definitely needs to account for differences in local risk factors and structural economic differences.  The federal/state governments need to support the communities, in terms of logistical support, and offering support in public health and economic expertise that smaller communities may lack - but the only way to truly do this "well" is a much more local and nuanced approach than we are currently using.

2) Those areas cannot reduce their level of vigilance. In rural northern Michigan, people thought they were immune. In the county where my aunt, uncle, and cousins live, all it took was one person who had recently traveled overseas, returned, and infected several other people in a popular restaurant before becoming symptomatic. The lack of mandatory quarantine for that person upon their return and the consequent lack of early contact tracing means that a county with 80 hospital beds is currently dealing with nearly 3 dozen known cases that are nearly all community spread.

And yes, 100% on this.  There's a small town (population a little over 10k) near me that has infection rates approaching those in NYC because a couple individuals broke quarantine, and now it's running through the community, including a nursing home.  While it's reasonable to relax certain rules in less-dense areas, citizens still need to recognize that this thing can and will wreak havoc on small towns if they're not careful.
Title: Re: How long can we wait while flattening the curve?
Post by: OtherJen on April 11, 2020, 12:09:16 PM
I actually don't have a problem with the idea of reopening rural areas, with two caveats.

1) Travel to and from these regions from more populous areas will have to be completely restricted. Otherwise, you will have the issue of outbreaks when people in more populated areas retreat to their second homes in more rural areas, which we've seen in ski towns and other vacation spots worldwide.

2) Those areas cannot reduce their level of vigilance. In rural northern Michigan, people thought they were safe. In the county where my aunt, uncle, and cousins live, all it took was one person who had recently traveled overseas, returned, and infected several other people in a popular restaurant before becoming symptomatic. The lack of mandatory quarantine for that person upon their return and the consequent lack of early contact tracing means that a county with 80 hospital beds is currently dealing with nearly 3 dozen known cases that are nearly all community spread.
Title: Re: How long can we wait while flattening the curve?
Post by: bacchi on April 11, 2020, 12:14:29 PM
My appeal has been that customized solutions must be had across the country without influence or fear of criticism.  Your argument seems to be that it is so bad there that no one else can act based on their own region's situation as if opening the parks in a rural WA county would have any impact on NY or Detroit.  Critical thinking is lost, driven by fear.

Wait. You just criticized LA County for extending their lockdown. Isn't that a local, customized, solution? They looked at the evidence and decided to extend their county lockdown.

I'm confused. Are you for regional solutions or are you against them?
Title: Re: How long can we wait while flattening the curve?
Post by: Abe on April 11, 2020, 12:20:54 PM
I actually don't have a problem with the idea of reopening rural areas, with two caveats.

1) Travel to and from these regions from more populous areas will have to be completely restricted. Otherwise, you will have the issue of outbreaks when people in more populated areas retreat to their second homes in more rural areas, which we've seen in ski towns and other vacation spots worldwide.

2) Those areas cannot reduce their level of vigilance. In rural northern Michigan, people thought they were immune. In the county where my aunt, uncle, and cousins live, all it took was one person who had recently traveled overseas, returned, and infected several other people in a popular restaurant before becoming symptomatic. The lack of mandatory quarantine for that person upon their return and the consequent lack of early contact tracing means that a county with 80 hospital beds is currently dealing with nearly 3 dozen known cases that are nearly all community spread.

Those are both goods points - and rural hospitals are fairly poorly equipped to handle critical care. Transporting patients in severe respiratory failure long distances is not safe, so they'd need to quickly identify and airlift out critical cases. Patients can deteriorate rather rapidly, so it's a bit of a risk. That's why county-by-county piecemeal decisions will probably be a bad idea. It'll have to be state-by-state or regi