Author Topic: How long can we wait while flattening the curve?  (Read 675120 times)

js82

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Re: How long can we wait while flattening the curve?
« Reply #1000 on: April 23, 2020, 11:27:34 AM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.

Wow that's bad, but also makes the decision making easier. I guess the silver lining if in those numbers is it is not nearly as deadly as first predicted?

Oh ok, IFR is infected fatality rate? 1/2 a percent is not great, but  likely an acceptable risk to society.

It's not great, 0.56% iFR, but it is higher than the University of Oxford estimate of 0.10-0.36%.  I'm fascinated what models show when this newer data is used. 

For example, can social distancing have a positive effect with a 21% infection rate and a R0 of 5.7?  Doesn't seem so, but as more and more accurate data are used the models should be less erratic.

At this point 0.5% seeks like a pretty accurate best estimate for IFR.  Anything less than 0.25% clearly doesn't fit the data.  The two best studies I've seen are this one, and one from germany that put it just shy of 0.4%.

Social distancing CAN have an effect in limiting total number of cases(and hence, total number of deaths), even if you can't wipe out/contain the virus.

The best way to think of it is this:  The epidemic progressively dies when R drops below 1.  R can drop from herd immunity (since immune population drops your effective R), and it can also drop from behaviors i.e. social distancing - these work synergistically with each other to cap the total number of cases.  R is also dynamic with respect to density(owing to differences in infection opportunities), so it's going to be easier to get there in less-dense rural areas than in dense cities.

At minimum this illustrates the value of maintaining effective protective protocols while opening businesses - basic steps with little/no economic impact but which produce a reduction in transmission rate can help reduce the terminal number of infections/deaths and improve the end outcome all around.

If your R = 2.5, you have effective herd immunity at 60% infection.  If your R = 2, that threshold drops to 50%.

If you can shave 20% off R through behaviors while keeping most things open, you save a whole lot of people from getting sick and potentially dying.

Even if you believe we can't contain the virus at this point(which is almost certainly the case in the USA) and want to open the economy, there are still a multitude of things we can and should be doing to reduce transmission, because they WILL save lives.
« Last Edit: April 23, 2020, 11:52:55 AM by js82 »

Midwest

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Re: How long can we wait while flattening the curve?
« Reply #1001 on: April 23, 2020, 11:32:21 AM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.

Wouldn't the vast majority of the deaths be in the elderly?  Assuming that's correct, the impact on the economy would be much less than if those deaths were distributed evenly across the population. 

js82

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Re: How long can we wait while flattening the curve?
« Reply #1002 on: April 23, 2020, 11:37:46 AM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.

Wouldn't the vast majority of the deaths be in the elderly?  Assuming that's correct, the impact on the economy would be much less than if those deaths were distributed evenly across the population.

Depends on the behavior people adopt - if the behavior is "I can't ever see Grandma/Grandpa until this is over" you have a very different impact than "I'm not going to risk going out myself, because I don't want to risk infecting my at-risk friends/family members".  Most people are doing some form of a comparison between these alternatives when evaluating how to handle their personal situations in this pandemic.

For people in living situations that involve extended families, the behavior will almost certainly be the latter - protecting themselves to protect their older relatives.

fattest_foot

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Re: How long can we wait while flattening the curve?
« Reply #1003 on: April 23, 2020, 11:45:32 AM »
Hi Spud, you make some decent points. Foremost of which is that their economy is more functional.

The metric of death per million is what it is, how else should we measure the impact of Covid between countries of different size? Impact on GDP [% loss of GDP per quarter or year] should certainly be a consideration but can only be measured in hindsight.

I disagree with your argument about Sweden being late in the Covid19 whole population infection process. Beginning at the 25th death, Sweden is only about 30 days along. Compare to USA which is 45 days along, and Italy is at around 60 days.

https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html

I sincerely hope you are entirely right and that Sweden will be a model for other countries down the line. Unfortunately we will not really know this for another 30 days. Of course, if the toll gets too high, Sweden will adjust accordingly and lock things down tighter. We will see.

It's basically a question of what the natural R0 of the virus would be, versus what the measures taken by individual countries knock it down to.

If its R0 is 5 for instance, and Sweden not doing much makes it 4.5, and the USA is down to 2, it means Sweden despite not having the virus in country as long would be much further along.
« Last Edit: April 23, 2020, 11:47:17 AM by fattest_foot »

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #1004 on: April 23, 2020, 11:54:42 AM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.

I dont think the economy can function with 26 million (and climbing) unemployed people either

Midwest

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Re: How long can we wait while flattening the curve?
« Reply #1005 on: April 23, 2020, 12:04:00 PM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.

Wouldn't the vast majority of the deaths be in the elderly?  Assuming that's correct, the impact on the economy would be much less than if those deaths were distributed evenly across the population.

Depends on the behavior people adopt - if the behavior is "I can't ever see Grandma/Grandpa until this is over" you have a very different impact than "I'm not going to risk going out myself, because I don't want to risk infecting my at-risk friends/family members".  Most people are doing some form of a comparison between these alternatives when evaluating how to handle their personal situations in this pandemic.

For people in living situations that involve extended families, the behavior will almost certainly be the latter - protecting themselves to protect their older relatives.

I wonder what portion of the country lives in a household a multi-generational household with 60 plus year-olds. 

If 60 plus year-olds are most at risk, we need to mitigate that risk versus shutting down everything.  That doesn't mean an end to social distancing, but it does mean thoughtful limitations versus the quarantine situation we have been in. 

js82

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Re: How long can we wait while flattening the curve?
« Reply #1006 on: April 23, 2020, 12:04:24 PM »
Hi Spud, you make some decent points. Foremost of which is that their economy is more functional.

The metric of death per million is what it is, how else should we measure the impact of Covid between countries of different size? Impact on GDP [% loss of GDP per quarter or year] should certainly be a consideration but can only be measured in hindsight.

I disagree with your argument about Sweden being late in the Covid19 whole population infection process. Beginning at the 25th death, Sweden is only about 30 days along. Compare to USA which is 45 days along, and Italy is at around 60 days.

https://www.nytimes.com/interactive/2020/03/21/upshot/coronavirus-deaths-by-country.html

I sincerely hope you are entirely right and that Sweden will be a model for other countries down the line. Unfortunately we will not really know this for another 30 days. Of course, if the toll gets too high, Sweden will adjust accordingly and lock things down tighter. We will see.

It's basically a question of what the natural R0 of the virus would be, versus what the measures taken by individual countries knock it down to.

If its R0 is 5 for instance, and Sweden not doing much makes it 4.5, and the USA is down to 2, it means Sweden despite not having the virus in country as long would be much further along.

It's noteworthy that the "Natural R0" of a virus isn't really a thing - R0 is just R with a certain set of underlying assumptions including density and behavior - but nonetheless it's a convenient metric for comparing contagiousness.  This means that you could estimate R in Wuhan or Detroit and get two different values - and neither one is intrinsically "right" or "wrong".  Ultimately, your baseline value for R is going to be quite a bit different in a sparse, rural community than in a city that normally puts crowds of people into public transportation.

I mention this because Sweden is probably playing with a lower median starting value of R than many other places, owing to its relatively lower density.  Compare with much of the rest of Europe, and Sweden is probably already starting with a lower rate of transmission than most of Europe, regardless of its citizens' behavior.

the_fixer

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Re: How long can we wait while flattening the curve?
« Reply #1007 on: April 23, 2020, 12:12:11 PM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.
Exactly, most restaurants and businesses that were closed here in Colorado had already taken a huge reduction in patrons a week or two before the governor closed them.

We went to chic-fil-a the week before the governor did the stay at home order and we were 1 of two couples in the entire restaurant. This is a restaurant that typically has a line out the door, no parking spots open and you are waiting for a seat.

Same with the local pizza place that we would go to once a week, as soon as cases started climbing it was empty, we were the only ones in a place that was normally packed.

I think people are dismissing the fact that people are not going to go out, travel and just start living life while we have so many cases and deaths they are going to focus on the essentials, keep vigilant and alert.

Honestly many businesses might be better off not being open VS having to staff and stock just to service very few customers and the employees might be better off on unemployment.

Talking about the US for reference


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Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #1008 on: April 23, 2020, 12:14:47 PM »
Latest numbers straight from CDC website https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

Sorry the formatting looks like crap. Emphasis mine, 16% of the population is responsible for 79% of the deaths.

   Covid Deaths     Population   % of population   % Death
All ages      23,358       327,167,434      
Under 1 year      0       3,848,208         1%              0%
1–4 years          2        15,962,067         5%           0%
5–14 years    1          41,075,169         13%           0%
15–24 years   21       42,970,800         13%           0%
25–34 years   183       45,697,774         14%           1%
35–44 years   462        41,277,888         13%           2%
45–54 years   1,257    41,631,699         13%           5%
55–64 years   2,993    42,272,636         13%          13%
65–74 years   5,093    30,492,316         9%          22%
75–84 years   6,429    15,394,374         5%          28%
85 years+       6,917    6,544,503         2%          30%


*I welcome any math checkers on here!
**And any medical folks on here who can tell me I am reading this data wrong.
            
                                          

Mariposa

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Re: How long can we wait while flattening the curve?
« Reply #1009 on: April 23, 2020, 12:18:04 PM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

How are you getting IFR of 0.56%?

Using NYC data, since the city reports both confirmed and probable deaths:
https://www1.nyc.gov/site/doh/covid/covid-19-data.page

15,400 deaths / (8.4mil * 21%) * 100% = 0.87% IFR

nereo

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Re: How long can we wait while flattening the curve?
« Reply #1010 on: April 23, 2020, 12:20:15 PM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.

I dont think the economy can function with 26 million (and climbing) unemployed people either

I understand your point, but to put this more directly, what would the unemployment be if we attempt to open up the economy which could result in the infection rate and mortality that we've been discussing?  The economical argument against opening up the economy prematurely is that - counter-intuitively - the unemployment and economic toll would actually be worse.   We risk an all-out crisis of confidence. 

This isn't new. Consider any corporate scandal which resulted in consumer deaths over the last several decades.  How that company has responded to those deaths, and how consumers feel about whether they can safely trust the company and the regulatory agencies which police them determine whether that scandal is a small setback, a monumental drag or the result of bankruptcy.  If we open up front-facing businesses and weeks later there's a substantial amount of deaths - including from people who never visited those establishments but got infexted through secondary contact - it seems almost certain that all of those businesses will suffer catastrophically for years to come.

Then view it from the workers' standpoint.  If your business opens but you have low confidence that you can work there without infecting yourself or your parents whom you are caring for, what options do you have?  Refuse to go back to work and you risk your unemployment eligibility.  Go back to work and you risk severe illness for yourself nad death to yourself and nthose you are closest to.

It's also craptastic for employers.  If a customer or employee gets sick and dies in your establishment you are in legal jeopardy.  Failure to do absolutely everything you can do reduce the spread of the virus means you are legally culpable.

FOr these reasons and others is why so many economists are warning of a steep "W' shaped recession (formerly the "double-dip") if we open too early.  We risk opening things only to have thigns shut down, through future outbreaks or bankruptcies or both.  All of which gets us back to the number of infected spreaders and our ability to accurately measure how many there are (i.e. testing).  If there are hundreds or thousands per region the above scenrios are all but assured.  Right now that seems to be where we are in many, many communities.  If the numebr is in the single digits (see above, discussion of Victoria, Australia) the spread will be slow enough at first that it can be mitigated and hopefully stopped completely.
« Last Edit: April 23, 2020, 12:52:15 PM by nereo »

Midwest

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Re: How long can we wait while flattening the curve?
« Reply #1011 on: April 23, 2020, 12:21:20 PM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.
Exactly, most restaurants and businesses that were closed here in Colorado had already taken a huge reduction in patrons a week or two before the governor closed them.

We went to chic-fil-a the week before the governor did the stay at home order and we were 1 of two couples in the entire restaurant. This is a restaurant that typically has a line out the door, no parking spots open and you are waiting for a seat.

Same with the local pizza place that we would go to once a week, as soon as cases started climbing it was empty, we were the only ones in a place that was normally packed.

I think people are dismissing the fact that people are not going to go out, travel and just start living life while we have so many cases and deaths they are going to focus on the essentials, keep vigilant and alert.

Honestly many businesses might be better off not being open VS having to staff and stock just to service very few customers and the employees might be better off on unemployment.

Talking about the US for reference


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When everything closed, we had even less data than we do now and we were being told masks weren't effective.  We now know, if you are under 65 without an underlying health condition and taking precautions, your odds are pretty good.   Plus people are really bored.

ReadySetMillionaire

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Re: How long can we wait while flattening the curve?
« Reply #1012 on: April 23, 2020, 12:49:04 PM »
Anybody have any data on how weather affects this thing?  I can't help but look at the broad trends and think transmission rate will dissipate when things warm up.

Florida (spring break), Louisiana (Mardi Gras), Texas (limited SAH order), etc. should be complete shitshows (Florida most especially), but they categorically are not anywhere near overwhelming their hospital systems. 

I don't see any signs of an outbreak in the Carribean, South America, northern Africa, or southern Italy/Greece.

The epicenters are all colder climates -- Wuhan, Northern Italy, NY/NJ.

I have not compiled all the data but SARS-CoV2 seems to be behaving like other coronaviruses -- it thrives in colder climates, but the transmission rates dissipate significantly in the hotter and more humid weather.

the_fixer

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Re: How long can we wait while flattening the curve?
« Reply #1013 on: April 23, 2020, 12:50:33 PM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.
Exactly, most restaurants and businesses that were closed here in Colorado had already taken a huge reduction in patrons a week or two before the governor closed them.

We went to chic-fil-a the week before the governor did the stay at home order and we were 1 of two couples in the entire restaurant. This is a restaurant that typically has a line out the door, no parking spots open and you are waiting for a seat.

Same with the local pizza place that we would go to once a week, as soon as cases started climbing it was empty, we were the only ones in a place that was normally packed.

I think people are dismissing the fact that people are not going to go out, travel and just start living life while we have so many cases and deaths they are going to focus on the essentials, keep vigilant and alert.

Honestly many businesses might be better off not being open VS having to staff and stock just to service very few customers and the employees might be better off on unemployment.

Talking about the US for reference


Sent from my iPhone using Tapatalk

When everything closed, we had even less data than we do now and we were being told masks weren't effective.  We now know, if you are under 65 without an underlying health condition and taking precautions, your odds are pretty good.   Plus people are really bored.
You could be right but more data cuts both ways.

We now know if you are obese or have high blood pressure you are at significant risk particularly for hospitalization. That is a large percentage of the US and not just above 65.

We also know that young people can get it and die from it when early on they were seen as invincible.

I guess we will see. I suspect that places will try to open, spend a bunch of money to attract an unsustainable amount of patrons they will financially struggle and probably go under due to cases going up and people staying home.

We will also see a second wave (even our governor admits it), it will probably happen just as people start to feel comfortable and remind them that the virus is still out there.

Personally we will go camping this summer if allowed, no air travel, wife will not be taking public transportation, no restaurants, no movies, no large venues we are pretty much keeping things locked down as reasonable as possible as are our friends and family for a while.

It is going to be a long slow grind to getting back to normal


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Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #1014 on: April 23, 2020, 12:56:42 PM »
https://www.cnbc.com/2020/04/23/new-york-antibody-study-estimates-13point9percent-of-residents-have-had-the-coronavirus-cuomo-says.html

Antibody study estimates 21% of New York City residents have been infected, or about 1.76 million people in the City limits alone.  With a virus R0 of 5.7 it seems unlikely that stopping the spread could be effective, unless we decide to drop a nuke on NYC.

Makes an iFR of about 0.56%.
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Would businesses be able to function with that level of mortality from a pandemic?  Most of what I've seen and read leads me to believe they could not.
Exactly, most restaurants and businesses that were closed here in Colorado had already taken a huge reduction in patrons a week or two before the governor closed them.

We went to chic-fil-a the week before the governor did the stay at home order and we were 1 of two couples in the entire restaurant. This is a restaurant that typically has a line out the door, no parking spots open and you are waiting for a seat.

Same with the local pizza place that we would go to once a week, as soon as cases started climbing it was empty, we were the only ones in a place that was normally packed.

I think people are dismissing the fact that people are not going to go out, travel and just start living life while we have so many cases and deaths they are going to focus on the essentials, keep vigilant and alert.

Honestly many businesses might be better off not being open VS having to staff and stock just to service very few customers and the employees might be better off on unemployment.

Talking about the US for reference


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When everything closed, we had even less data than we do now and we were being told masks weren't effective.  We now know, if you are under 65 without an underlying health condition and taking precautions, your odds are pretty good.   Plus people are really bored.
You could be right but more data cuts both ways.

We now know if you are obese or have high blood pressure you are at significant risk particularly for hospitalization. That is a large percentage of the US and not just above 65.

We also know that young people can get it and die from it when early on they were seen as invincible.

I guess we will see. I suspect that places will try to open, spend a bunch of money to attract an unsustainable amount of patrons they will financially struggle and probably go under due to cases going up and people staying home.

We will also see a second wave (even our governor admits it), it will probably happen just as people start to feel comfortable and remind them that the virus is still out there.

Personally we will go camping this summer if allowed, no air travel, wife will not be taking public transportation, no restaurants, no movies, no large venues we are pretty much keeping things locked down as reasonable as possible as are our friends and family for a while.

It is going to be a long slow grind to getting back to normal


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The numbers don't really show that so far.

*Sure sure if you don't have an immune system it can kill you, but so can lots of other normal stuff.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #1015 on: April 23, 2020, 01:08:38 PM »
[We also know that young people can get it and die from it when early on they were seen as invincible.]

The numbers don't really show that so far.

*Sure sure if you don't have an immune system it can kill you, but so can lots of other normal stuff.

I don't understand what you mean.  Certainly the mortality rate is much greater for senior citizens, but people in their 30s and 40s are unquestionably dying, many of whom would be considered basically 'healthy' beforehand. 

These are the breadwinners, the primary caretakers, literally the most expensive people to lose from a population.

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Re: How long can we wait while flattening the curve?
« Reply #1016 on: April 23, 2020, 01:17:49 PM »
[We also know that young people can get it and die from it when early on they were seen as invincible.]

The numbers don't really show that so far.

*Sure sure if you don't have an immune system it can kill you, but so can lots of other normal stuff.

I don't understand what you mean.  Certainly the mortality rate is much greater for senior citizens, but people in their 30s and 40s are unquestionably dying, many of whom would be considered basically 'healthy' beforehand. 

These are the breadwinners, the primary caretakers, literally the most expensive people to lose from a population.

https://www.usatoday.com/story/news/health/2020/04/07/new-york-coronavirus-deaths-data-shows-most-had-underlying-illnesses/2960151001/

7% of the deaths in NY were under 50.  In my state it's less than 2%.

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #1017 on: April 23, 2020, 01:20:47 PM »
I just posted the numbers up thread.

Per the CDC

The ~150 million people under the age of 35 are responsible for <1% of the total deaths.

The ~94 million people over the age of 55 are responsible ffor 92% of the deaths.

*The numbers are CDC but the math is mine, I have made mistakes before.




fattest_foot

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Re: How long can we wait while flattening the curve?
« Reply #1018 on: April 23, 2020, 01:21:19 PM »
The numbers don't really show that so far.

*Sure sure if you don't have an immune system it can kill you, but so can lots of other normal stuff.

Younger people without comorbidities that die from this are an extreme outlier. And it happens all the time that people just drop dead. We shouldn't be making policy on fringe cases.

And this whole idea that "well, companies may open up and struggle, and they'll eventually fail" is crazy to me. Right now the alternative is they just stay shut due to government mandate and go under. How is that a better option? At least give them the option to try to survive.

That's like holding someone underwater and saying, "Yeah, they'd probably drown anyway if I let up. So I may as well just keep them pinned under the water."

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #1019 on: April 23, 2020, 01:22:44 PM »
[We also know that young people can get it and die from it when early on they were seen as invincible.]

The numbers don't really show that so far.

*Sure sure if you don't have an immune system it can kill you, but so can lots of other normal stuff.

I don't understand what you mean.  Certainly the mortality rate is much greater for senior citizens, but people in their 30s and 40s are unquestionably dying, many of whom would be considered basically 'healthy' beforehand. 

These are the breadwinners, the primary caretakers, literally the most expensive people to lose from a population.

https://www.usatoday.com/story/news/health/2020/04/07/new-york-coronavirus-deaths-data-shows-most-had-underlying-illnesses/2960151001/

7% of the deaths in NY were under 50.  In my state it's less than 2%.

Sounds accurate. Under 55 age group (71% of the population) is 8% of deaths.
« Last Edit: April 23, 2020, 01:25:04 PM by Jon Bon »

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #1020 on: April 23, 2020, 01:24:21 PM »
It will be interesting to see, after this subsides, if the death rate declines significantly overall, since C19 seems to kill pretty much the elderly and the sick/unhealthy. Without sounding callous about it, these were people who were much more likely to die in the next few years anyway than the general population. If a lot of them die (hopefully this doesn't happen) I would imagine we'd see a significantly reduced death rate for a decade or so going forward.

-W

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Re: How long can we wait while flattening the curve?
« Reply #1021 on: April 23, 2020, 01:29:47 PM »
[We also know that young people can get it and die from it when early on they were seen as invincible.]

The numbers don't really show that so far.

*Sure sure if you don't have an immune system it can kill you, but so can lots of other normal stuff.

I don't understand what you mean.  Certainly the mortality rate is much greater for senior citizens, but people in their 30s and 40s are unquestionably dying, many of whom would be considered basically 'healthy' beforehand. 

These are the breadwinners, the primary caretakers, literally the most expensive people to lose from a population.

https://www.usatoday.com/story/news/health/2020/04/07/new-york-coronavirus-deaths-data-shows-most-had-underlying-illnesses/2960151001/

7% of the deaths in NY were under 50.  In my state it's less than 2%.

ok, that seems to confirm what I said above.

fattest_foot

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Re: How long can we wait while flattening the curve?
« Reply #1022 on: April 23, 2020, 01:40:44 PM »
It will be interesting to see, after this subsides, if the death rate declines significantly overall, since C19 seems to kill pretty much the elderly and the sick/unhealthy. Without sounding callous about it, these were people who were much more likely to die in the next few years anyway than the general population. If a lot of them die (hopefully this doesn't happen) I would imagine we'd see a significantly reduced death rate for a decade or so going forward.

-W

More relevant to MMM in general, but I had read an article last week discussing Social Security. When this was kicking off in January, it was thought that this would "solve" demography problems, especially in countries with upside-down demographic pyramids (lots of old people). For the US, that would've meant a program like Social Security might be in a better spot.

But since the virus isn't nearly as bad as anticipated it's really not having any impact on our own demography. On top of that, it's looking like we're going to cut another 2+ years off the SS Trust Fund because the entire program is taking in significantly less revenue with the massive amount of unemployment.

It's these types of long term impacts of unemployment that no one seems to be considering. Only the short term stuff like businesses closing and immediate unemployment. We're going to be feeling this 1-2 month (hopefully not much more) shutdown for years or decades. It really is a self imposed Great Depression type scenario. We're just in the early stages and most people can't recognize it.

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Re: How long can we wait while flattening the curve?
« Reply #1023 on: April 23, 2020, 01:41:17 PM »
Various government leaders have said the past few weeks that anti-body testing is crucial to getting America back to work.

https://www.nytimes.com/2020/04/23/nyregion/coronavirus-antibodies-test-ny.html?action=click&module=Spotlight&pgtype=Homepage

Accurate antibody testing is a critical tool to determine if the pandemic has slowed enough to begin restarting the economy.

But, per the article (various snips):

Hours before Mr. Cuomo’s presentation, a top health official in New York City cautioned against making too much of the usefulness of the test results when it comes to critical decisions over social distancing and reopening the economy, particularly in identifying immunity.

The city’s top official for disease control, Dr. Demetre C. Daskalakis, wrote in an email alert on Wednesday that the tests “may produce false negative or false positive results,” pointing to “significant voids” in using the science to pinpoint immunity.

“Given the current lack of evidence” that any blood test for antibodies is indicative of “durable immunity,” Dr. Daskalakis wrote, “it should not be used for that purpose.”

“It is a way to say this person had the disease and they can go back into the work force,” Dr. Zucker said. “A strong test like we have can tell you that you have antibodies.”

Sign up to receive an email when we publish a new story about the coronavirus outbreak.  But he cautioned that the length of any such immunity remained unknown. “The amount of time, we need to see. We don’t know that yet,” he said, adding, “They will last a while.”

Mr. Cuomo said antibody testing results, along with hospitalization numbers, would influence the state’s reopening strategy, noting that the number of people being hospitalized was still too high to consider easing restrictions.

But he cautioned against using antibody testing as a criteria to allow people into the world. “To use it as a fulcrum for when someone can travel or work, I think we have to be extremely careful as a society in doing that,” he said.

Some health experts say that if tests return high rates of false positives — results that incorrectly report a person has antibodies — they could encourage people to abandon protective measures and risk worsening the virus’s spread. Others warn that the true value of coronavirus antibodies is still unknown.

“I’m very ambivalent about these tests, because we don’t really know yet through the science what it means to have an antibody,” said Dr. Joan Cangiarella, the vice-chair of clinical operations at NYU Langone Health’s pathology department.


So apparently antibody testing isn't as important as we were lead to believe and the accuracy and meaning of it is also being questioned.

To me it seems like the government has put itself into a corner that it can't get out of.  There is no stated goal and eradication of the disease seems impossible.  A vaccine is likely a long way from fruition, and may very well never come -- last I read there are at least 30 strains of COVID-19 that have been documented. 

I wonder what the government will do?  Opening society up will likely cause the virus to spread rapidly with more deaths.  Keeping society closed the virus seems like it will also spread (but not as quickly) while having increasingly significant economic and social disruptions. 

Any ideas how this will all play out?  It seems to me the government got antibody data it didn't want to believe and doesn't know how to handle.  Be careful what you wish for, I suppose.  I bet the government was hoping the amount of infections would be a lot lower.  And what will states outside of the Northeast US do?  They likely don't have the case numbers NY and NJ do.

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Re: How long can we wait while flattening the curve?
« Reply #1024 on: April 23, 2020, 01:42:30 PM »
https://www.usatoday.com/story/news/health/2020/04/07/new-york-coronavirus-deaths-data-shows-most-had-underlying-illnesses/2960151001/

7% of the deaths in NY were under 50.  In my state it's less than 2%.

Why is that? Are people in your state healthier? Or are most of your state's deaths from groups of older, susceptible, populations (ie., nursing homes)?

Why wouldn't your state eventually match the 7% that NY is seeing?

Midwest

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Re: How long can we wait while flattening the curve?
« Reply #1025 on: April 23, 2020, 01:59:58 PM »
https://www.usatoday.com/story/news/health/2020/04/07/new-york-coronavirus-deaths-data-shows-most-had-underlying-illnesses/2960151001/

7% of the deaths in NY were under 50.  In my state it's less than 2%.

Why is that? Are people in your state healthier? Or are most of your state's deaths from groups of older, susceptible, populations (ie., nursing homes)?

Why wouldn't your state eventually match the 7% that NY is seeing?

I would trust the CDC or NY numbers more than my state due to the larger data set.
« Last Edit: April 23, 2020, 02:02:32 PM by Midwest »

mathlete

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Re: How long can we wait while flattening the curve?
« Reply #1026 on: April 23, 2020, 02:04:10 PM »
Most of my posting in this thread has been based on an assumption that we value life like the US government does, which is generally to say, age-agnostic.

If we want to value old life less, I'm willing to hear that out. Especially since I'm in my early 30s and I think I can keep my parents adhering to reasonable caution.

But before we discuss that, we should consider whether or not the US is actually resource constrained in terms of battling the economic impact of the lockdown given that we have a central bank that can set interest rates, a treasury that can print money, and a congress that can borrow that money at the rates set by the Fed.

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Re: How long can we wait while flattening the curve?
« Reply #1027 on: April 23, 2020, 02:08:47 PM »
I think people are dismissing the fact that people are not going to go out, travel and just start living life while we have so many cases and deaths they are going to focus on the essentials, keep vigilant and alert.

That's actually the main reason that I think we will be able to open things sooner rather than later. People are going to continue to use caution and distance themselves, so the chances of a big spike in new cases will be decreased. I expect an opened up society to look a lot more like Sweden in mid-April than a NYC in mid-March.

Midwest

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Re: How long can we wait while flattening the curve?
« Reply #1028 on: April 23, 2020, 02:10:21 PM »
[We also know that young people can get it and die from it when early on they were seen as invincible.]

The numbers don't really show that so far.

*Sure sure if you don't have an immune system it can kill you, but so can lots of other normal stuff.

I don't understand what you mean.  Certainly the mortality rate is much greater for senior citizens, but people in their 30s and 40s are unquestionably dying, many of whom would be considered basically 'healthy' beforehand. 

These are the breadwinners, the primary caretakers, literally the most expensive people to lose from a population.

https://www.usatoday.com/story/news/health/2020/04/07/new-york-coronavirus-deaths-data-shows-most-had-underlying-illnesses/2960151001/

7% of the deaths in NY were under 50.  In my state it's less than 2%.

ok, that seems to confirm what I said above.

People in their 30's and 50's are dying, but at a much lower rate.  A low enough rate that many will be willing to accept the risk.  If we pullout the deaths of healthcare workers, fire and police from those #'s, I suspect the risk in the 30-50 category would be even lower.

I would hope we could decrease the infection rates among first responders with adequate PPE.


waltworks

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Re: How long can we wait while flattening the curve?
« Reply #1029 on: April 23, 2020, 02:17:29 PM »
Most of my posting in this thread has been based on an assumption that we value life like the US government does, which is generally to say, age-agnostic.

If we want to value old life less, I'm willing to hear that out. Especially since I'm in my early 30s and I think I can keep my parents adhering to reasonable caution.

But before we discuss that, we should consider whether or not the US is actually resource constrained in terms of battling the economic impact of the lockdown given that we have a central bank that can set interest rates, a treasury that can print money, and a congress that can borrow that money at the rates set by the Fed.

I think you can simultaneously recognize the inherent dignity/value of a life for it's own sake, while at the same time orienting public policy to do more to help the young with more life ahead of them than the old. So we don't want to just say "let granny die", but likewise we should be more willing to make sacrifices to save infants than nursing home residents.

Taken to an extreme that would mean leaving granny out on the ice, of course, and nobody wants that. But as heartless as it might sound, I'd be willing to let everyone over, say, 90 die in order to prevent, say, a multi-decade great depression in which my ESL students never get to go to college or have a decent job.

The resource constrained question has yet to be answered. If supply chains are badly enough f'd up, we might be looking at all sorts of real resource constraints in a few more months. Many less fortunate parts of the world may see starvation.

I guess looking at the US in a vacuum, we're *maybe* not resource constrained depending on how well things can function longer term. For the world, the shit is already hitting the fan and we may inadvertently kill off a lot of young people to save folks in nursing homes.

-W

Michael in ABQ

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Re: How long can we wait while flattening the curve?
« Reply #1030 on: April 23, 2020, 02:32:50 PM »
Based on some numbers previously posted, 29% of the US population is over 55. That age cohort represents the vast majority of deaths worldwide.

I'm currently in Africa where the demographics are completely different with most countries around 5-10% over 55 and very few in the 75+ category. The overwhelming majority of the population is under 30 where so far the death rate has been very low. So while the medical infrastructure (hospital beds, ICU beds, ventilators, etc.) is minimal here, as the virus spreads it will probably have a lesser impact than we've seen in Europe, east Asia, and the US. Basically the places that are rich enough for people to have multiple comorbidities and still make it to their 70s or older.

Midwest

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Re: How long can we wait while flattening the curve?
« Reply #1031 on: April 23, 2020, 02:34:27 PM »
Most of my posting in this thread has been based on an assumption that we value life like the US government does, which is generally to say, age-agnostic.

If we want to value old life less, I'm willing to hear that out. Especially since I'm in my early 30s and I think I can keep my parents adhering to reasonable caution.

But before we discuss that, we should consider whether or not the US is actually resource constrained in terms of battling the economic impact of the lockdown given that we have a central bank that can set interest rates, a treasury that can print money, and a congress that can borrow that money at the rates set by the Fed.

I think you can simultaneously recognize the inherent dignity/value of a life for it's own sake, while at the same time orienting public policy to do more to help the young with more life ahead of them than the old. So we don't want to just say "let granny die", but likewise we should be more willing to make sacrifices to save infants than nursing home residents.

Taken to an extreme that would mean leaving granny out on the ice, of course, and nobody wants that. But as heartless as it might sound, I'd be willing to let everyone over, say, 90 die in order to prevent, say, a multi-decade great depression in which my ESL students never get to go to college or have a decent job.

The resource constrained question has yet to be answered. If supply chains are badly enough f'd up, we might be looking at all sorts of real resource constraints in a few more months. Many less fortunate parts of the world may see starvation.

I guess looking at the US in a vacuum, we're *maybe* not resource constrained depending on how well things can function longer term. For the world, the shit is already hitting the fan and we may inadvertently kill off a lot of young people to save folks in nursing homes.

-W

Very well said.  Although ESL and other underprivileged kids will be hurt the most, all children are being negatively effected.  They are cut off from their friends and being educated by a screen and hopefully with their parents assistance.  Short term that's ok, but it's not a great alternative long-term.

happyuk

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Re: How long can we wait while flattening the curve?
« Reply #1032 on: April 23, 2020, 02:57:33 PM »
I think the UK/US/French governments and other authorities are under the impression that they are the ones who will decide when the lockdown is over. My money's on the public being the ones who will decide. I've a feeling it's starting to happen - the slow, gradual increase of background traffic hum is one of a number of perceptible signals.

The police might be able to manage it at the moment, issuing the odd fine here and there, but once that trickle turns into a flood it will become unmanageable. They wouldn't be able to cope with the paperwork and the normal everyday policing issues will return. At the best of times the police struggle to deal with routine crime issues so issuing fines for not adhering to the lockdown is going to be low on their list of priorities. It should also be remembered that the police police by public consent, in the UK at least. If there is a noticeable lockdown, it is because the public generally agree that it's a good thing and consent to it. If the public ignores the lockdown then they will have shown that they have withdrawn that consent with respect to that particular issue.

The supermarkets currently have a one in, one out policy but that will only last as longs as the public permits. And as long as shareholders permit their profits taking a hammering. No security guard is going to be able to prevent dozens of people wandering into the store as they feel like it, ignoring social distancing. How would they physically stop it? Once the public takes matters into its own hands things will quickly snowball and that would mean the government would have to re-evaluate and manage the situation in a different way.

It's a numbers game and once the number of people ignoring/forgetting the lockdown reaches a critical point the lockdown has failed. It is slowly starting to die over here. People have had enough, and are ready to slowly start opening things back up and many people want to go back to work.

American GenX

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Re: How long can we wait while flattening the curve?
« Reply #1033 on: April 23, 2020, 03:05:41 PM »

I say lock it down as long as it takes.  I care just as much about those older people as I do any younger people, and for many of the younger people that live, they are suffering kidney failure, strokes, and other complications.  It's not just about life and death.

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #1034 on: April 23, 2020, 03:12:51 PM »
Yes, around here people have started congregating in at least small groups again. My guess is that most of our town (huge international tourist destination that had more cases per capita than NYC as of a few weeks ago) has had it/been exposed already. They are just testing everyone at this point and based on the numbers so far I think we'll be back up and running in another week.

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Re: How long can we wait while flattening the curve?
« Reply #1035 on: April 23, 2020, 03:20:49 PM »
On doing the maths and crunching the numbers my conclusion is that the economic onslaught is far worse than the Kung Flu.

Most people understand the risk to health and well being and are prepared to accept that and use common sense in order to go to work and start the economic machine again. In six weeks we have fallen into the worse economic crisis most of us have seen, excluding the pensioners who grew up during the Great Depression.

We also know that our government can only print so much stimulus money before that tool is no longer effective. If we only had a month to wait for a vaccine, I could argue that we all just sit tight and suck it up. But the best estimate is 12 months or more before that is an option. We will not survive that kind of shut down.

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Re: How long can we wait while flattening the curve?
« Reply #1036 on: April 23, 2020, 03:56:11 PM »
Not sure if the uncertainty range of the NYC antibody test is shown anywhere.  That is, when the figure of 13.9% of NY state, and 21.2% of NYC with antibodies, the uncertainty (range) of those numbers is very wide based on low sample size.  For example Sweden just released a report stating 11% of Stockholm residents showed antibodies, but the range is 11% to 33% due to low sample rate/uncertainty.

My point is any calculation derived from this like IFR can easily be off by a factor of 2 or more.  I.e. if Stockholm is at the upper end of 33% with antibodies versus 11%, the IFR would range from 0.3% to 1.0%.

Will be interesting to compare Stockholm (light lockdown) to NYC later.  Stockholm is 974,073 pop., approx. 4200 people/square km.  NYC 8.4 million pop., 10,194 people/square km (with Manhattan alone being 25846 people/square km).  Close to 10 times population, more than double the density.

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Re: How long can we wait while flattening the curve?
« Reply #1037 on: April 23, 2020, 04:15:44 PM »
Most of my posting in this thread has been based on an assumption that we value life like the US government does, which is generally to say, age-agnostic.

If we want to value old life less, I'm willing to hear that out. Especially since I'm in my early 30s and I think I can keep my parents adhering to reasonable caution.

But before we discuss that, we should consider whether or not the US is actually resource constrained in terms of battling the economic impact of the lockdown given that we have a central bank that can set interest rates, a treasury that can print money, and a congress that can borrow that money at the rates set by the Fed.

Maybe the US isn't resource-constrained, but given the fact that our Senate majority leader just stated a preference for States to declare bankruptcy rather than give them federal assistance makes me pretty convinced that they'll handle the economic fallout as well as they've handled the public health crisis thus far.

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Re: How long can we wait while flattening the curve?
« Reply #1038 on: April 23, 2020, 04:23:48 PM »
Quote from: Buffalo Bulski
That iFR is critical. Let’s use your number and extrapolate. Let’s say that we eventually end up with a 50% infection rate across the US over say the next year. So let’s say .0056 times .5 times the US population which is roughly 332 million. Or roughly 929,000. Pretty horrible. But in context we’ve already put 26 million people out of work to delay, not avoid, that reckoning. Also, about 2.8 million people die every year in the US in any case.

Latest numbers straight from CDC website https://www.cdc.gov/nchs/nvss/vsrr/covid19/index.htm

Sorry the formatting looks like crap. Emphasis mine, 16% of the population is responsible for 79% of the deaths.

   Covid Deaths     Population   % of population   % Death
All ages      23,358       327,167,434      
Under 1 year      0       3,848,208         1%              0%
1–4 years          2        15,962,067         5%           0%
5–14 years    1          41,075,169         13%           0%
15–24 years   21       42,970,800         13%           0%
25–34 years   183       45,697,774         14%           1%
35–44 years   462        41,277,888         13%           2%
45–54 years   1,257    41,631,699         13%           5%
55–64 years   2,993    42,272,636         13%          13%
65–74 years   5,093    30,492,316         9%          22%
75–84 years   6,429    15,394,374         5%          28%
85 years+       6,917    6,544,503         2%          30%
                   

Taking these together, of people under 64, 21% of 929k deaths is 195k. That’s about 4 times the military deaths in Vietnam (47.4k according to a quick google) or about two thirds the WWII deaths (291.5k).  Even if we’re willing to throw the retirees under the bus, I don’t think the public will accept this.

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #1039 on: April 23, 2020, 04:27:56 PM »
Vietnam was *teenagers* through 20s dying, not people "under 64".

If you're going to make that comparison, you need to use the 34 and under death rate at the very least. The under 24 number would probably be more honest, though.

-W
« Last Edit: April 23, 2020, 04:39:07 PM by waltworks »

Midwest

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Re: How long can we wait while flattening the curve?
« Reply #1040 on: April 23, 2020, 04:42:11 PM »
It also assumes 100% of the population contracts it and that there is a better alternative.  I don't think being locked down for a year or 2 is a viable alternative.  i do think masks will be popular.

nereo

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Re: How long can we wait while flattening the curve?
« Reply #1041 on: April 23, 2020, 05:13:09 PM »


People in their 30's and 50's are dying, but at a much lower rate.

This is an instance of people looking at the same data-set and drawing vastly different conclusions.  We can all agree that the proportions of people in younger age brackets dying is far less than those in the older age brackets.  However, the likelihood of a 40 year old man dying in a 'normal' year is about 0.21% per SSA data.  A 65yo is 1.58%; 7.5 times higher. FWIW a 70yo is 11x more likely.

Dig a little deeper and it gets even more interesting:  leading causes of death for a 40yo are (in order) unintentional injuries, suicide/homicide, and then cancer and chronic heart disease.  Deaths from infectious diseases are quite rare, with the most coming from complications due to HIV (around 1.2%).

In other words - at least in the US and other western countries a 40 year old is not supposed to die from a contagion.  FWIW influenza ranks in at < 1.0%.  Compare that to 65yo group, where 8.6% of deaths are due to Respiratory diseases and influenza (or 8.6x the frequency of 40yo deaths).   So having 7% of the total death toll be people under 50 is pretty darn concerning to me. This is a group that's normally so well armored from disease mortality (at least in developed countries) that it's not even part of the normal doctor-patient conversation when they do get sick.

Jon Bon

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Re: How long can we wait while flattening the curve?
« Reply #1042 on: April 23, 2020, 05:31:05 PM »
Interesting points.

While I hesitate to even do this because they are pretty different animals why not it's the internet!
 
It looks like the flu kills slightly more evenly, but I dont think it is statistically relevant because the fatality numbers are so different. 23k(covid) versus 5k (flu)

I guess I am trying to talk as much math and stats as possible and not buy into some of the craziness. If I have a point at all here, is that we do in fact accept a percentage of young people dying from respiratory diseases?



   % Covid Deaths   % Flu Deaths
Under 1 year   0.0%   0.2%
1–4 years         0.01%   0.5%
5–14 years   0.00%   0.7%
15–24 years   0.09%   0.7%
25–34 years   0.78%   2.2%
35–44 years   1.98%   3.5%
45–54 years   5.38%   8.7%
55–64 years   12.81%   18.4%
65–74 years   21.80%   22.0%
75–84 years   27.52%   22.2%
85 +            29.61%   20.8%

*Standard math/medical check disclaimers.




Midwest

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Re: How long can we wait while flattening the curve?
« Reply #1043 on: April 23, 2020, 05:31:25 PM »


People in their 30's and 50's are dying, but at a much lower rate.

This is an instance of people looking at the same data-set and drawing vastly different conclusions.  We can all agree that the proportions of people in younger age brackets dying is far less than those in the older age brackets.  However, the likelihood of a 40 year old man dying in a 'normal' year is about 0.21% per SSA data.  A 65yo is 1.58%; 7.5 times higher. FWIW a 70yo is 11x more likely.

Dig a little deeper and it gets even more interesting:  leading causes of death for a 40yo are (in order) unintentional injuries, suicide/homicide, and then cancer and chronic heart disease.  Deaths from infectious diseases are quite rare, with the most coming from complications due to HIV (around 1.2%).

In other words - at least in the US and other western countries a 40 year old is not supposed to die from a contagion.  FWIW influenza ranks in at < 1.0%.  Compare that to 65yo group, where 8.6% of deaths are due to Respiratory diseases and influenza (or 8.6x the frequency of 40yo deaths).   So having 7% of the total death toll be people under 50 is pretty darn concerning to me. This is a group that's normally so well armored from disease mortality (at least in developed countries) that it's not even part of the normal doctor-patient conversation when they do get sick.

I'm not dismissing the virus or the fact it's killing people (including young people).  However, if we assume a 0.6% fatality rate and 50% infection rate you are looking at 1 million deaths across the US.  If 5% of those 1 million are people 45-54 (population 41.6 million), then someone in that age range as a .1% chance of dying.  I'll wear a mask, keep my 6 feet etc, but proportionally my odds are pretty good.  If you combine mask wearing, hand washing, and a certain amount of social distancing, my odds are even better as the infection rate will go down. 

Given the projections thus far, I think the death toll in the US will be much lower that the 1 million used above.  If that's the case, my odds are even lower.

I think we need to weigh the damage to the economy and society against the risk of death.  That doesn't mean opening up large sporting events, etc at this juncture.  I do, however, think we need to get as many people back to work as possible while mitigating the risk to the extent possible.
« Last Edit: April 23, 2020, 05:34:04 PM by Midwest »

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #1044 on: April 23, 2020, 06:20:46 PM »
I guess I am trying to talk as much math and stats as possible and not buy into some of the craziness. If I have a point at all here, is that we do in fact accept a percentage of young people dying from respiratory diseases?

Yes, if we say, for example, that Covid is 10 times worse/more deadly than the flu (within the realm of reason based on what we know right now) then you'd think we'd do *something* about the flu. But we don't. Flu shots aren't mandatory. Staying home if you're sick isn't required. Wearing a mask? Don't make me laugh.

So yeah, we accept quite a bit of death (with quite a few more of them young) in exchange for convenience/the economy.

-W

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #1045 on: April 23, 2020, 06:33:07 PM »
The way I see it, deaths are like your budget - if you have to fiddle with the numbers and argue to try to make it look good, you're really in the shit.

Gremlin

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Re: How long can we wait while flattening the curve?
« Reply #1046 on: April 23, 2020, 07:09:06 PM »
Note: it is quite possible for the virus to be a very serious problem and at the same time for governments to be using it to arrogate more power to themselves, and abuse it.

https://www.theage.com.au/politics/victoria/victorian-government-blocks-opposition-calls-for-scrutiny-of-pandemic-response-20200423-p54mo6.html

I agree with this.  It concerns me that governments of both sides in Australia have used this to reduce scrutiny.  This has happened in Victoria under a Labor Govt.  It's happened in Qld under a Labor Govt.  The Federal Coalition Govt on the 23rd of March ordered the parliament into recess until mid-August.  None of these actions are appropriate in a democracy.

Paper Chaser

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Re: How long can we wait while flattening the curve?
« Reply #1047 on: April 23, 2020, 07:46:32 PM »


People in their 30's and 50's are dying, but at a much lower rate.

This is an instance of people looking at the same data-set and drawing vastly different conclusions.  We can all agree that the proportions of people in younger age brackets dying is far less than those in the older age brackets.  However, the likelihood of a 40 year old man dying in a 'normal' year is about 0.21% per SSA data.  A 65yo is 1.58%; 7.5 times higher. FWIW a 70yo is 11x more likely.

Dig a little deeper and it gets even more interesting:  leading causes of death for a 40yo are (in order) unintentional injuries, suicide/homicide, and then cancer and chronic heart disease.  Deaths from infectious diseases are quite rare, with the most coming from complications due to HIV (around 1.2%).

In other words - at least in the US and other western countries a 40 year old is not supposed to die from a contagion.  FWIW influenza ranks in at < 1.0%.  Compare that to 65yo group, where 8.6% of deaths are due to Respiratory diseases and influenza (or 8.6x the frequency of 40yo deaths).   So having 7% of the total death toll be people under 50 is pretty darn concerning to me. This is a group that's normally so well armored from disease mortality (at least in developed countries) that it's not even part of the normal doctor-patient conversation when they do get sick.

I'm not sure we can simply extrapolate the current numbers across the whole population (or whatever percentage of the population you think might be infected in a given timeframe), especially for the younger demographics. The virus is most lethal for unhealthy people. The percentage of unhealthy people in the older demographics is higher than younger demographics. Id wager that the majority of those 7% of people 50 and under that have died thus far have had significant risk factors (obesity, perhaps) that made them more susceptible to this virus. That can't continue indefinitely. Eventually the virus runs out of at-risk people to kill and that's likely to occur in young demographics much sooner than older ones simply because there are fewer unhealthy, at-risk people in those younger demographics. In other words, I'd expect the fatality rate among younger demographics to be highest initially, (as the weakest members of the demographics succumb to the virus) and then decrease over time as there would be fewer and fewer easy targets. If we're dealing with this virus for several more months, after it's all said and done, I'm not sure that we'll still have 7% of deaths in the under 50 grouping.
« Last Edit: April 23, 2020, 08:00:58 PM by Paper Chaser »

Gremlin

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Re: How long can we wait while flattening the curve?
« Reply #1048 on: April 23, 2020, 08:08:01 PM »

For those outside Australia, the Federal and State Governments (at both ends of the political spectrum) collectively announced a week ago that the conditions for winding back restrictions would be:
  • Australia has in place sufficient capabilities to undertake widespread testing
  • Australia has in place sufficient capabilities to undertake widespread case tracking
  • Australia has a suitable isolation policies in place, including the ability to isolate localised communities to contain future outbreaks
Those conditions exist today.

...and yet literally every single state and territory in Australia is investing heavily in further increasing capacity to test and track. 

The Fed Govt is spruiking their case tracking app that is still being developed. 

The Premier of NSW this morning said "We have used this time during restrictions when we have seen a drop in the number of new cases to prepare the health system, to prepare the community for what would occur if we did raise those restrictions."  She also said that she wants to see NSW testing capabilities pass above 8,000 a day. 

The Federal Chief Medical Officer, Brendan Murphy, said yesterday again that "any reduction in social-distancing measures would be dependent on beefing up the public health response, which would mean testing like you've never tested before".

Are all nine state, territory and federal governments, from both ends of the political spectrum, that far off the mark in their assessment of what's required?

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1049 on: April 23, 2020, 08:24:45 PM »
They are simply being super-conservative, because they know that the general public, which has no understanding of cost/benefit, would rather see another $200 billion in stimulus spent (and a 10% hike in unemployment) and an additional 20 deaths, than only $100 billion in stimulus spent, a 5% hike in unemployment, and an additional 20+x deaths. They might have a number in mind for x but they're not releasing the modelling and they're not engaging with us honestly about QALY and the relative worth of human lives versus money.

 

Wow, a phone plan for fifteen bucks!