Author Topic: How long can we wait while flattening the curve?  (Read 675173 times)

ROF Expat

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Re: How long can we wait while flattening the curve?
« Reply #1550 on: May 03, 2020, 02:22:49 AM »
I agree there’s ageism at play here.  Why is a younger person’s potential contribution worth more than an older person’s existing contribution?  Is it measured only in economic terms?  We on this forum should know better than that.  North American culture puts too little value on elders.  In other cultures, the elderly are revered for their knowledge and wisdom.  Interestingly, in the animal kingdom (humans ARE animals), an adult will always abandon a youngster if it’s attempts to protect it put the adult at risk.  We do the opposite, for emotional reasons.

I have to respectfully disagree with the idea that "an adult will always abandon a youngster if it's attempts to protect it put the adult at risk."  Kin selection and altruism are well documented in the animal kingdom, from spiders that allow themselves to be eaten by their young to adults that put themselves at risk (or die) to protect their young.  Many social animals support young (even when they are not their own offspring).  One can argue the degree to which these are "emotional" decisions, but they are quantified in formulas like the Price equation and Hamilton's rule.  I'm not a biologist (just a hobbyist), but animals with more sophisticated social structures, and greater "investment" in their young via fewer offspring, longer gestation periods, and greater training have a clear incentive to protect their young.  Their are fewer examples of animals that act altruistically to protect the old or injured, but those exist as well. 

Examples from nature aside, on a cultural basis (for Americans), our most basic national document describes "Life" (along with Liberty and the pursuit of happiness) as an unalienable right.  Logical or not, we are comfortable with the idea of doctors performing triage when medical resources do not match need, and we celebrate those who voluntarily give up their lives for others (firefighters, Arland Williams of Air Florida Flight 90), but many of us are deeply uncomfortable with government codifying and implementing the same thing. 

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1551 on: May 03, 2020, 02:30:39 AM »
Let me be clear - I'm a former statistician but by no means an epidemiologist. I believe that the disease is very serious and can kill a lot of people.

My disagreement has to do with the value of a life - I believe that the lives of the very elderly, bluntly, are worth far less when we're talking about society-wide sacrifices. I think that is the disconnect for me.

I agree that it's a shame this has become a partisan issue for many people.

-W

I agree with that. I take a broadly utilitarian stance when it comes to state healthcare spending (I'm otherwise not completely utilitarian but I think if the state is to intervene, it should do so on utilitarian grounds). It's strangely controversial though, and even people who agree can't be seen to say it, because our society has so many hang-ups about making value judgments about lives (even though we literally do it every time we drive on a highway, or go to a casino, or order from McDonald's).

This crisis has minted an amazing amount of market timers, and now armchair epidemiologists and economists.  It's kind of amazing to think some mustachian without a degree in either epidemiology or economics knows better than literally the entire field of experts that devote their lives to studying these things.

Unfortunately, in recent decades we've developed a culture where questioning expert opinions has become common place, and all too often people convince themselves that they know more than the people who literally spend their entire careers studying.  Often they bring up some topic as if no one has ever thought of it before (and which has been extensively studied and often dismissed for good reason).

Global climate change created an army of denialists that suddenly thought they could detect flaws in the analysis of literally petabytes of data made by thousands of independent researchers.  Anti-vaxxers suddenly knew more about medicine after reading a few hundred pages of blog posts than doctors who had spent 7+ years in training.  Now we've got market economists and epidemiologists.

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

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

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

Globalisation may have harmed poorly educated Americans but it's lifted millions of third-world workers out of poverty, so I'd say on the whole it's been an amazing success. 100 million Americans versus 500 million Chinese/Indian workers? I'd say the latter are more important...by a factor of about 5.

But here's another truth that you just can't say in public because we're meant to all pretend that there's something special about the lives of our countrymen as opposed to general humanity.
« Last Edit: May 03, 2020, 02:35:15 AM by Bloop Bloop »

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #1552 on: May 03, 2020, 03:28:47 AM »
So someone will have to provide data showing an increase in suicides if they’re going to use that as an argument against the lockdown
"Dear everyone, please save me the trouble of spending five minutes with google, because I thought maybe that when a person was sacked and broke they'd be happy."
Okay.

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

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

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

Oh and see figure 1 here - source 4

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #1553 on: May 03, 2020, 03:42:07 AM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.


lol how much overlap do we think there is between folks who are protesting to open up the country ASAP and those who are believe 'all lives matter'

I believe all lives matter. However, as I showed earlier, we'll see some deaths however we handle it, my concern is how to minimise the overall loss of life. For example, if you have a bushfire threatening homes and send firefighters to fight it, some of those firefighters will probably die. But we'd rather than a few firefighters die than a few hundred people die in their homes. This is horrendous for the firefighters and their families, but 3 deaths is better than 300.

Now, in the US, as in the UK it's a moot point: they've let things go so far that they're going to get many virus deaths AND many other deaths. I have no advice for them except to tear up your countries and start again.

But other countries who acted early like RoK and Australia, or who have been through the worst and are now emerging into the light like Spain and Italy, are looking at virus deaths OR other deaths.

Plina

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Re: How long can we wait while flattening the curve?
« Reply #1554 on: May 03, 2020, 03:44:48 AM »
I agree there’s ageism at play here.  Why is a younger person’s potential contribution worth more than an older person’s existing contribution?  Is it measured only in economic terms?  We on this forum should know better than that.  North American culture puts too little value on elders.  In other cultures, the elderly are revered for their knowledge and wisdom.  Interestingly, in the animal kingdom (humans ARE animals), an adult will always abandon a youngster if it’s attempts to protect it put the adult at risk.  We do the opposite, for emotional reasons.

For me it seems that you value the elders a lot as both your president and his competition is both of an age that would make them totally ineligiable in many countries.

Would most of the plus 80 years have a quality of life if they survived? Even many of the younger survivors seems to have a long rehab in waiting for them. Personally, If I would not be able to live a normal life I would prefer to die.


MayDay

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Re: How long can we wait while flattening the curve?
« Reply #1555 on: May 03, 2020, 05:42:48 AM »
I agree there’s ageism at play here.  Why is a younger person’s potential contribution worth more than an older person’s existing contribution?  Is it measured only in economic terms?  We on this forum should know better than that.  North American culture puts too little value on elders.  In other cultures, the elderly are revered for their knowledge and wisdom.  Interestingly, in the animal kingdom (humans ARE animals), an adult will always abandon a youngster if it’s attempts to protect it put the adult at risk.  We do the opposite, for emotional reasons.

For me it seems that you value the elders a lot as both your president and his competition is both of an age that would make them totally ineligiable in many countries.

Would most of the plus 80 years have a quality of life if they survived? Even many of the younger survivors seems to have a long rehab in waiting for them. Personally, If I would not be able to live a normal life I would prefer to die.

I think many Americans have weird hangups about talking about death. My in laws are mid 70's and absolutely refuse to discuss their wishes. It is just straight to "what, are you trying to kill me?".
 

Also many do not understand how horrible many interventions are. Medical providers themselves want DNR's because they know how horrible it will likely be. My mother just convinced my grandfather to get one established because she knows what an 85 year olds QOL will be after a month on a ventilator (she's a nurse and has worked in ICU's).  Yet in this country we'll pump the elderly full of chemo right up until they die because we don't want to accept that they are definitely going to die.

Anyway. Clearly I a pro death panel. IMO we should have locked down hard and early. Instead we have this half assed situation.


boy_bye

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Re: How long can we wait while flattening the curve?
« Reply #1556 on: May 03, 2020, 06:56:12 AM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

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

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #1557 on: May 03, 2020, 07:02:50 AM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.
wow. in a forum FULL of shitty anti-fat sentiment, this is one of the shittiest things i've ever read.

Yes. Both this and and “I believe that the lives of the very elderly, bluntly, are worth far less when we're talking about society-wide sacrifices” strike me as particularly shitty and lacking in compassion and empathy. At lleast they’re finally being honest about their underlying motivations and we can see who they are.

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1558 on: May 03, 2020, 07:07:17 AM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.
wow. in a forum FULL of shitty anti-fat sentiment, this is one of the shittiest things i've ever read.

Yes. Both this and and “I believe that the lives of the very elderly, bluntly, are worth far less when we're talking about society-wide sacrifices” strike me as particularly shitty and lacking in compassion and empathy. At lleast they’re finally being honest about their underlying motivations and we can see who they are.

You're shooting the messenger rather than dealing with the message.

Being obese is a contraindication to all sorts of surgeries, and you can bet that surgeons discuss this with their patients, and yet the obesity rate is not getting better. Covid-19 has a minuscule chance of affecting your health (in my country, the infection rate is approximately 0.0056% and the death rate is 0.00036%). So if all the other, much larger, more direct risks to one's health are not going to change behaviour or lifestyle, then covid-19 sure as heck won't. That's not to say that there aren't also societal factors in play - it's not a black or white proposition and was never set up as one.

And again, compassion and empathy are completely compatible with a trolley problem of the type discussed here. If I see a speeding train hurtling towards a 90-year old and a 3-year-old and I can only save one, then all things being equal, I am going to save the 3-year-old. 100 times out of 100. That does not mean that I lack compassion, nor does it mean I don't believe the 90-year-old still retains their humanity. It's a simple weighing mechanism.

obstinate

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Re: How long can we wait while flattening the curve?
« Reply #1559 on: May 03, 2020, 07:26:17 AM »
Anyway. Clearly I a pro death panel. IMO we should have locked down hard and early. Instead we have this half assed situation.
This is also an important point. From its peak death rate on February 15th, China cut its deaths to a tenth by March 15. OTOH, my state, NY, looks like it will only manage a 1/3rd reduction during the same peak to peak + 1 month time frame. We're doomed, in other words.

LWYRUP

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Re: How long can we wait while flattening the curve?
« Reply #1560 on: May 03, 2020, 07:50:21 AM »
But here's another truth that you just can't say in public because we're meant to all pretend that there's something special about the lives of our countrymen as opposed to general humanity.

Yes, because if people catch on they get very angry that their elite fucked them over and then you get a very toxic political culture where people respond by doing irrational things like voting Donald Trump into office.  Which is terrible for the country as whole, but if you are a factory worker and the other politicians basically say the same things you are saying, well people will notice. 

Things can get even worse, poor class relationships basically caused Cuba, Venezuela, etc. to become failed states.  Social cohesion is extremely important.  I think there needs to be some give and take on issues like globalization and income inequality to keep the system stable and prosperous for all, and so as a result on a political level we really can't just act like there is no difference between citizens and non-citizens (particularly non-resident non-citizens). 

Yes. Both this and and “I believe that the lives of the very elderly, bluntly, are worth far less when we're talking about society-wide sacrifices” strike me as particularly shitty and lacking in compassion and empathy. At lleast they’re finally being honest about their underlying motivations and we can see who they are.

I think FIRE is a very individualistic pursuit, so many of the people that are trying for it can be very individualistic in their analysis of other things.  Sometimes that is good, but sometimes it can come off as pretty callous.  Frequently I find myself actually agreeing with the logical propositions people are putting forward but surprised with how aggressively some things are framed. 

There is a difference between understanding that physical fitness is very important and obesity is a public health concern we should all, as individuals and a society, be working to combat, and making it seem like... it doesn't matter if some obese person dies of a disease because they deserved it and their life wasn't valuable anyways.  Now, I know people don't really believe that, but sometimes when people write things flippantly on the internet that is how it gets received by others. 

Laserjet3051

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Re: How long can we wait while flattening the curve?
« Reply #1561 on: May 03, 2020, 08:07:09 AM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

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

I agree, we should all continue to celebrate morbid obesity as has been the trend over the past few years in popular culture. Physicians discouraging obesity really have it all wrong.

boy_bye

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Re: How long can we wait while flattening the curve?
« Reply #1562 on: May 03, 2020, 08:21:47 AM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

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

I agree, we should all continue to celebrate morbid obesity as has been the trend over the past few years in popular culture. Physicians discouraging obesity really have it all wrong.

i'd rather be "morbidly obese" than a massive asshole, personally, but we're all free to make our own choices.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #1563 on: May 03, 2020, 08:29:51 AM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

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

I agree, we should all continue to celebrate morbid obesity as has been the trend over the past few years in popular culture. Physicians discouraging obesity really have it all wrong.

i'd rather be "morbidly obese" than a massive asshole, personally, but we're all free to make our own choices.

Nobody is being a major asshole for pointing out the health risks or social costs of obesity. 

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #1564 on: May 03, 2020, 08:35:56 AM »
For most folks, controlling obesity is as simple as eating better and exercising.

The problem is, as simple as that might be, there are a lot of roadblocks that are commonly run into.  Constant advertising and availability of unhealthy foods, stress and less time to enact a healthy lifestyle, deeply ingrained unhealthy patterns, a tendency to eat prepared foods (which are invariably made to taste good rather than be good for you), conflicting and often confusing information regarding diet/exercise, lack of good role models to follow . . . these issues exist and need to recognized as real and challenging for many people.

The solution to obesity is typically quite simple, but one shouldn't assume that this makes it easy.  For a great many people, it's one of the hardest things they've had to face.

boy_bye

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Re: How long can we wait while flattening the curve?
« Reply #1565 on: May 03, 2020, 09:01:41 AM »
For most folks, controlling obesity is as simple as eating better and exercising.

The problem is, as simple as that might be, there are a lot of roadblocks that are commonly run into.  Constant advertising and availability of unhealthy foods, stress and less time to enact a healthy lifestyle, deeply ingrained unhealthy patterns, a tendency to eat prepared foods (which are invariably made to taste good rather than be good for you), conflicting and often confusing information regarding diet/exercise, lack of good role models to follow . . . these issues exist and need to recognized as real and challenging for many people.

The solution to obesity is typically quite simple, but one shouldn't assume that this makes it easy.  For a great many people, it's one of the hardest things they've had to face.

LOL ok

ender

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Re: How long can we wait while flattening the curve?
« Reply #1566 on: May 03, 2020, 09:08:52 AM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.


This is notreally addressing the spirit of the objection.

With covid, the government nearly worldwide is full on taking unprecedented actions to preserve the safety of citizens. This is significantly more than a public health program. The equivalent response for obesity would be more akin to mandating which foods are healthy and then ordering all business/restaurants to no longer allow consumption and purchase of anything that is considered a risk factor for causing obesity.





js82

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Re: How long can we wait while flattening the curve?
« Reply #1567 on: May 03, 2020, 09:18:40 AM »
And again, compassion and empathy are completely compatible with a trolley problem of the type discussed here. If I see a speeding train hurtling towards a 90-year old and a 3-year-old and I can only save one, then all things being equal, I am going to save the 3-year-old. 100 times out of 100. That does not mean that I lack compassion, nor does it mean I don't believe the 90-year-old still retains their humanity. It's a simple weighing mechanism.

Agreed 100%.

For leaders in a scenario like this there are cases where they're trying to choose between a number of different approaches, and the one that ultimately gets chosen is dependent on how much they choose to value certain things.  It's not a fun or easy discussion, but a necessary one.

From my perspective, having to weigh the outcomes is not the problem.  The problem is dismissal of the forms of hardship(or risk) that others are encountering if they don't align with one's own world view.  There's a huge difference between acknowledging that this is a difficult problem that will unfortunately end up with winners and losers and acknowledging the gravity of the situation for everyone, and dismissing either the financial distress that this crisis is causing people or the health risks it presents to many.

Where/when I've called people out in this discussion it's not been about contrarian viewpoints themselves, but about being dismissive of the fears/concerns of others - unfortunately this thread has ventured into that space at times.

Padonak

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Re: How long can we wait while flattening the curve?
« Reply #1568 on: May 03, 2020, 09:34:22 AM »
Let me be clear - I'm a former statistician but by no means an epidemiologist. I believe that the disease is very serious and can kill a lot of people.

My disagreement has to do with the value of a life - I believe that the lives of the very elderly, bluntly, are worth far less when we're talking about society-wide sacrifices. I think that is the disconnect for me.

I agree that it's a shame this has become a partisan issue for many people.

-W

This is 100% spot on. I couldn't have said it better.

Plina

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Re: How long can we wait while flattening the curve?
« Reply #1569 on: May 03, 2020, 09:35:10 AM »
I agree there’s ageism at play here.  Why is a younger person’s potential contribution worth more than an older person’s existing contribution?  Is it measured only in economic terms?  We on this forum should know better than that.  North American culture puts too little value on elders.  In other cultures, the elderly are revered for their knowledge and wisdom.  Interestingly, in the animal kingdom (humans ARE animals), an adult will always abandon a youngster if it’s attempts to protect it put the adult at risk.  We do the opposite, for emotional reasons.

For me it seems that you value the elders a lot as both your president and his competition is both of an age that would make them totally ineligiable in many countries.

Would most of the plus 80 years have a quality of life if they survived? Even many of the younger survivors seems to have a long rehab in waiting for them. Personally, If I would not be able to live a normal life I would prefer to die.

I think many Americans have weird hangups about talking about death. My in laws are mid 70's and absolutely refuse to discuss their wishes. It is just straight to "what, are you trying to kill me?".
 

Also many do not understand how horrible many interventions are. Medical providers themselves want DNR's because they know how horrible it will likely be. My mother just convinced my grandfather to get one established because she knows what an 85 year olds QOL will be after a month on a ventilator (she's a nurse and has worked in ICU's).  Yet in this country we'll pump the elderly full of chemo right up until they die because we don't want to accept that they are definitely going to die.

Anyway. Clearly I a pro death panel. IMO we should have locked down hard and early. Instead we have this half assed situation.

I don’t think it is only americans that can not understand the lack of QOL. We have had some discussions why 80+ year old people in nursing homes are not put on ventilator. They get their care in nursing homes and can die without interventions that in the end only would prolong dieing. To get admitted to a nursing you are not normally able to take care of your self anymore.

In my family, we can discuss death. After my grandmothers funeral we had a discussion about different burial customs. That also lead to a discussion of how we want to get buried bit we have not discussed what to due about intensive care. I know my grandfather have discussed the continuation of cancer treatment with his doctor as he mentioned it. In this case they can prolong life some years with a QOL.I have friends that have had old parents in palliative care but basically the treatment ends when there is no hope left.

Padonak

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Re: How long can we wait while flattening the curve?
« Reply #1570 on: May 03, 2020, 09:47:11 AM »

Let's say that these folks have an average of 10 QALRs left, to account for the assumption they're mostly old and sick. Let's say you value a whole life of QALRs at $10M, and you assume everyone will have a hundred good years, just to keep the math even. That means the average COVID death comes at a cost of around $1M. The cost to NY State of all these deaths would therefore be on the order of $131B.  But we've already lost 2/7th of those years, so call it $100B.



How did you arrive at $10M as the value of a whole life of QALRs? The average person doesn't contribute anything close $10M to the economy over their lifetime. I don't have the exact number but it's probably an order of magnitude less than $10M.

Bloop Bloop

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Re: How long can we wait while flattening the curve?
« Reply #1571 on: May 03, 2020, 09:51:52 AM »

Let's say that these folks have an average of 10 QALRs left, to account for the assumption they're mostly old and sick. Let's say you value a whole life of QALRs at $10M, and you assume everyone will have a hundred good years, just to keep the math even. That means the average COVID death comes at a cost of around $1M. The cost to NY State of all these deaths would therefore be on the order of $131B.  But we've already lost 2/7th of those years, so call it $100B.



How did you arrive at $10M as the value of a whole life of QALRs? The average person doesn't contribute anything close $10M to the economy over their lifetime. I don't have the exact number but it's probably an order of magnitude less than $10M.

The value of a life isn't determined by its economic output, otherwise we'd be shooting certain people on sight. The value of a life is determined by all sorts of measures, and can only ever be approximated (for obvious reasons), but it does need to be quantified in some way because many public policy measures require us to value relative risks between certain things. I think it's fair to say that life inherently has a great, but not infinite, value.

T-Money$

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Re: How long can we wait while flattening the curve?
« Reply #1572 on: May 03, 2020, 10:00:17 AM »
Back to science...

https://www.ft.com/content/0409a776-8b85-11ea-a109-483c62d17528




   Obesity dangers make Covid-19 a rebuke to unequal societies

Excess body fat seems to matter more than heart or lung disease, or smoking, when it comes to catching the virus

© Jonathan McHugh 2020
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Camilla Cavendish MAY 1 2020 402
The writer is a senior fellow at Harvard University and an adviser to the UK Department of Health and Social Care

Covid-19 is perhaps the reckoning for ignoring two things that might once have seemed unrelated. Leaders were urged to prepare for a viral pandemic, and to tackle widening gaps between the health of rich and poor. Covid-19 is the reckoning. We are repeatedly told that age is the main risk factor with this virus. But so, it seems, is being poor. 

“Why are you surprised?” asks my friend Jo, an intensive care nurse in the National Health Service. “It’s nothing new.” The patients Jo sees are disproportionately overweight or obese. Many have type-2 diabetes, kidney problems or hypertension. People with those conditions, she points out, were always more prone to end up in ICU. They have weakened immune systems which often relate to chronic stress from low-income jobs, poor diet and physical inactivity. 


We urgently need to understand the connections between these conditions and Covid-19. In France, the US and UK, figures suggest that patients who are overweight are at significantly greater risk. In New York City, a study of 4,000 Covid-19 patients found that obesity is the second strongest predictor, after their age, of whether someone over 60 will need critical care. Surprisingly for a virus that hits the lungs, the researchers say that excess body fat seems to matter more than heart or lung disease, or smoking — perhaps because obesity triggers chronic inflammation, leaving sufferers more susceptible. 


A second New York study says that being overweight is the main driver of whether younger people will be hospitalised with Covid-19. Patients under 60, the researchers found, are twice as likely to need intensive care if they have a body mass index over 30, and 3.6 times more likely to need it with a BMI over 35. Once in ICU, we must remember, survival odds are tragically only 50:50.

Looking back to the swine flu outbreak, it is clear this should have been anticipated. In 2009, 51 per cent of Californians who died from the H1N1 Influenza A were obese: this was 2.2 times more than the prevalence of obesity in the state population. Obesity is well known to be a risk factor for chronic health conditions, including strokes, heart attacks and hypertension. One group of scientists last week called on healthcare systems to start systematically measuring the “metabolic parameters” of patients: body mass index, waist circumference, glucose and insulin levels, in order to calculate their risk of complications from the disease. It is incredible this isn’t already happening. 

This is not just about body weight. People of normal weights can have impaired metabolic health. A recent commentary in the journal Nature stated that “patients with type-2 diabetes and metabolic syndrome might have up to 10 times greater risk of death when they contract Covid-19”. 

Both of these conditions disproportionately afflict people of south Asian and Afro-Caribbean descent, who are being hit hard. We need to know whether metabolic syndrome might in some way explain the shocking death toll of Filipino nurses in the UK and the US. They tend to give their all to the job; some may have been working without adequate protection. But are they also physically more vulnerable?

To find out, we need better data and an open debate. Last week, three-quarters of Covid-19 patients in 268 NHS ICUs were overweight or obese, according to the Intensive Care National Audit and Research Centre. Almost half were younger than 60. These figures do not include some of the oldest people, who are dying in care homes. Nevertheless, they suggest that locking down everyone over 70 may not be the best way to stratify risk. 

I am not arguing that slim, fit people are safe. Our immune systems tend to weaken as we age, and our metabolisms slow down (which in turn can lead to weight gain). Experts are also looking at whether “viral load”, — repeated exposure — may explain why some young, healthy professionals treating the sick are struck down by this virus. But if this growing body of evidence is anywhere near the mark, it suggests that the UK and US will fare especially badly in the crisis. France’s chief epidemiologist has already taken a swipe at the US, warning that Americans are likely to suffer the most from Covid-19 because obesity is “a major risk factor”. 

The US is the fattest nation in the OECD, and the UK is the fattest in Europe after Portugal. Both countries also have abhorrent health inequalities. In some parts of England, there is now a 12-year gap in healthy life expectancy between rich and poor. Deficient housing, pollution, insecure work, poor diets: all of these drive chronic disease, which strikes at younger and younger ages. We have loaded the dice against the poor and this is being cruelly exposed by the pandemic. 

It is notable that Japan has recorded relatively low mortality rates, despite being the world’s oldest society. There are many possible explanations. But Japan has low obesity and its government has an ambitious, successful public health programme. 

How might we arm our populations against this virus, and for the future? We must turbocharge public health programmes that can reverse chronic conditions such as type-2 diabetes. We should realise that lockdowns which prevent people from exercising will store up trouble. And not bracket people simply by age.

There is much more to learn about Covid-19. But it seems clear that poverty, obesity and its related diseases make some people old before their time. 

obstinate

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Re: How long can we wait while flattening the curve?
« Reply #1573 on: May 03, 2020, 10:13:49 AM »

Let's say that these folks have an average of 10 QALRs left, to account for the assumption they're mostly old and sick. Let's say you value a whole life of QALRs at $10M, and you assume everyone will have a hundred good years, just to keep the math even. That means the average COVID death comes at a cost of around $1M. The cost to NY State of all these deaths would therefore be on the order of $131B.  But we've already lost 2/7th of those years, so call it $100B.



How did you arrive at $10M as the value of a whole life of QALRs? The average person doesn't contribute anything close $10M to the economy over their lifetime. I don't have the exact number but it's probably an order of magnitude less than $10M.
This is what I recollect hearing the US government values them at. It seems like a decent ballpark estimate, but you could argue up or down. As mentioned by others, life is definitely not valued by its economic output. I mean not in our society. There are hypothetical societies that might do that, but I don't want to live in one.

Padonak

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Re: How long can we wait while flattening the curve?
« Reply #1574 on: May 03, 2020, 10:57:01 AM »

Let's say that these folks have an average of 10 QALRs left, to account for the assumption they're mostly old and sick. Let's say you value a whole life of QALRs at $10M, and you assume everyone will have a hundred good years, just to keep the math even. That means the average COVID death comes at a cost of around $1M. The cost to NY State of all these deaths would therefore be on the order of $131B.  But we've already lost 2/7th of those years, so call it $100B.



How did you arrive at $10M as the value of a whole life of QALRs? The average person doesn't contribute anything close $10M to the economy over their lifetime. I don't have the exact number but it's probably an order of magnitude less than $10M.
This is what I recollect hearing the US government values them at. It seems like a decent ballpark estimate, but you could argue up or down. As mentioned by others, life is definitely not valued by its economic output. I mean not in our society. There are hypothetical societies that might do that, but I don't want to live in one.

If everybody's life is valued at let's say 10X their economic output, where do we as a society get the money when we have to pay to save their lives or extend them by another year?

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #1575 on: May 03, 2020, 11:04:24 AM »
It's really not that tricky, Padonak. Per capita GDP is $60k/year. If you expect to live ~80 years, that's around $5 million.

That's the purely economic value of a person. There is also, of course, non-economic value in a human life. So $10 million seems reasonable to me.

-W

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #1576 on: May 03, 2020, 11:28:58 AM »
What's the economic output of someone who retired early?

Padonak

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Re: How long can we wait while flattening the curve?
« Reply #1577 on: May 03, 2020, 11:36:04 AM »
What's the economic output of someone who retired early?
In terms of productivity it's zero for those who are 100% retired. Which is why if I am retired, I am ok with society spending all my assets to save or extend my life and not one dollar more.
« Last Edit: May 03, 2020, 11:38:09 AM by Padonak »

dandarc

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Re: How long can we wait while flattening the curve?
« Reply #1578 on: May 03, 2020, 11:56:25 AM »
@Padonak - How do you measure the economic output an individual produces? Saying "the average person does not produce anything close to $10 million over their lifetime." I'm curious how you measure economic output to come to that conclusion.

mm1970

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Re: How long can we wait while flattening the curve?
« Reply #1579 on: May 03, 2020, 12:00:17 PM »
Why on Earth there isn't a consensus recommendation to reduce the amount of obesity in light of COVID-19 research I have no idea
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.
wow. in a forum FULL of shitty anti-fat sentiment, this is one of the shittiest things i've ever read.

Yes. Both this and and “I believe that the lives of the very elderly, bluntly, are worth far less when we're talking about society-wide sacrifices” strike me as particularly shitty and lacking in compassion and empathy. At lleast they’re finally being honest about their underlying motivations and we can see who they are.
It's a real bummer.  I mean, I've been obese and overweight.  I guess I was worth less of a person then?  I've got relatives who are obese, diabetic, with cancer who have had hip replacements.  These aren't lazy people.  They have never been lazy people. 

I also know people who have had multiple hip replacements who were never obese, people with inherited joint pain, and what's wrong with being ugly?  I'm a wrinkled, graying, almost-50 year old woman who wears glasses.  I look at my hands, and see my mother's hands.  I look in the mirror, and I see that sagging chin/neck skin that she had.  I come back from a run and those big thighs are still jiggling, cellulite on full display.  Who really gives a shit?

Oh, and some of my relatives are old too.  I'd honestly rather my relatives live another 10 years and spend ALLLL their money however they want/ need (including on medical care) rather than leave me a bunch of money.  These older relatives are worth a lot more than some of the younger people I know.

I'm not going to disagree with someone else's sentiment about the amount of money spent on the last year of life.  That's a tricky bit.  I imagine you don't always know if someone will get better and live another 10 years or not.

RetiredAt63

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Re: How long can we wait while flattening the curve?
« Reply #1580 on: May 03, 2020, 12:06:01 PM »
What's the economic output of someone who retired early?

When I look around me, almost all the volunteer activity is being done by retirees. For example, from Garden Ontario's annual report, "In 2018, 278 horticultural societies recorded 527,241 volunteer hours in community service across Ontario."

The rest is being done by high school students who need their volunteer hours to graduate.


Padonak

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Re: How long can we wait while flattening the curve?
« Reply #1581 on: May 03, 2020, 12:07:50 PM »
@Padonak - How do you measure the economic output an individual produces? Saying "the average person does not produce anything close to $10 million over their lifetime." I'm curious how you measure economic output to come to that conclusion.

I think what @waltworks mentioned a few posts back (GDP per capita X life expectancy) is a good starting point.

dandarc

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Re: How long can we wait while flattening the curve?
« Reply #1582 on: May 03, 2020, 12:13:00 PM »
@Padonak - How do you measure the economic output an individual produces? Saying "the average person does not produce anything close to $10 million over their lifetime." I'm curious how you measure economic output to come to that conclusion.

I think what @waltworks mentioned a few posts back (GDP per capita X life expectancy) is a good starting point.
OK, so about $4.9 million per person then ($20.5 trillion / 330 million) * 78 years.

GuitarStv

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Re: How long can we wait while flattening the curve?
« Reply #1583 on: May 03, 2020, 12:14:16 PM »
What's the economic output of someone who retired early?

When I look around me, almost all the volunteer activity is being done by retirees. For example, from Garden Ontario's annual report, "In 2018, 278 horticultural societies recorded 527,241 volunteer hours in community service across Ontario."

The rest is being done by high school students who need their volunteer hours to graduate.

Shut up and die, freeloaders!  We don't value that useless volunteer stuff!

 :P

dandarc

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Re: How long can we wait while flattening the curve?
« Reply #1584 on: May 03, 2020, 12:15:29 PM »
What's the economic output of someone who retired early?

When I look around me, almost all the volunteer activity is being done by retirees. For example, from Garden Ontario's annual report, "In 2018, 278 horticultural societies recorded 527,241 volunteer hours in community service across Ontario."

The rest is being done by high school students who need their volunteer hours to graduate.
Volunteer work isn't included in GDP. So obviously it has no value to society.

OtherJen

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Re: How long can we wait while flattening the curve?
« Reply #1585 on: May 03, 2020, 01:21:01 PM »
What's the economic output of someone who retired early?

When I look around me, almost all the volunteer activity is being done by retirees. For example, from Garden Ontario's annual report, "In 2018, 278 horticultural societies recorded 527,241 volunteer hours in community service across Ontario."

The rest is being done by high school students who need their volunteer hours to graduate.
Volunteer work isn't included in GDP. So obviously it has no value to society.

Apparently that's the assumption. Meanwhile, I'm the only person younger than 50 in my group of hospice bedside singers and on the board of directors of a local voter education/advocacy non-profit. In fact, there are only a couple of us younger than 60 in both of those groups. Older people do a huge amount of unpaid community work and are often the most reliable donors. But none of that gets funneled into the stock market so it must have no value.

RetiredAt63

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Re: How long can we wait while flattening the curve?
« Reply #1586 on: May 03, 2020, 01:22:15 PM »
What's the economic output of someone who retired early?

When I look around me, almost all the volunteer activity is being done by retirees. For example, from Garden Ontario's annual report, "In 2018, 278 horticultural societies recorded 527,241 volunteer hours in community service across Ontario."

The rest is being done by high school students who need their volunteer hours to graduate.
Volunteer work isn't included in GDP. So obviously it has no value to society.

You forgot the sarcasm /s :P.  We all know that volunteer work (which massively included women's work) isn't valued.  Who needs Meals on Wheels?  Or Big Brother/Big Sister?  Or people who drive ill people to their doctor's appointments?  Or the adults involved in children's activities (Scouts/Guides, soccer, etc.).  Or, or, or.  Not to mention all the grandparents looking after grandchildren, for a variety of reasons.

And OtherJen's comment about the age of volunteers reflects my reality.

use2betrix

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Re: How long can we wait while flattening the curve?
« Reply #1587 on: May 03, 2020, 01:48:36 PM »
Let me be clear - I'm a former statistician but by no means an epidemiologist. I believe that the disease is very serious and can kill a lot of people.

My disagreement has to do with the value of a life - I believe that the lives of the very elderly, bluntly, are worth far less when we're talking about society-wide sacrifices. I think that is the disconnect for me.

I agree that it's a shame this has become a partisan issue for many people.

-W

I think I may love you Walt for stating this so clearly. I mean, many dance around the topic of us old people being of less value but yeesh you just out and out said it.

To add - elderly and high risk people do always have the option of spending the time at home and taking significantly more steps to reduce their risk of contracting the virus.

As a young and healthy person, I feel the risk is worth me, as there are many other significant races I take every day (my job, driving to work, chance I could contract another uncontrollable disease outside my control).

I still plan to take reasonable precautions both to protect myself and others in the event I’m going to be infected.

My biggest concern is all the people that will make really stupid decisions and take no precautions at all. I.e. all those spring breakers..

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1588 on: May 03, 2020, 01:57:58 PM »
Here's a graph showing the number of deaths per state. I cut off the Y-axis at 1000 deaths to make the differences between states more easy to visualize (hence NY, NJ just disappearing off the top of the graph). Most states that are not super rural (i.e. Montana, Idaho) are continuing upwards with deaths, with variable success in flattening curves. Let me know what you all think, if this is useful.

Cassie

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Re: How long can we wait while flattening the curve?
« Reply #1589 on: May 03, 2020, 02:34:42 PM »
I am 65 and have asthma and Hbp both of which run in my family.If there aren’t enough ventilators to go around of course they should go to younger people.  I don’t intend to spend my last few years of life on expensive medical treatments. I am a realist. We have stayed home for 2 months and I am looking forward to a gradual reopening.  Something’s will be too risky for awhile. People can only be locked up for so long.

Northern gal

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Re: How long can we wait while flattening the curve?
« Reply #1590 on: May 03, 2020, 03:38:29 PM »
China isnt known to care too much about amillion people dying here or there.

Yet they started this whole lockdown saga.

Maybe they know something CNN doesnt? Like that it is a pretty nasty bug all around, for example.

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #1591 on: May 03, 2020, 07:10:28 PM »
Quote
There have been public health programmes about obesity in the West for at least 50 years. If joint pain, hip replacements, poor sexual function, looking ugly, having lower limbs amputated, heart disease and stroke haven't motivated people to put down the pizza and beer and go for a walk, I don't think covid-19 will do it.

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

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

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



Yes. Both this and and “I believe that the lives of the very elderly, bluntly, are worth far less when we're talking about society-wide sacrifices” strike me as particularly shitty and lacking in compassion and empathy. At lleast they’re finally being honest about their underlying motivations and we can see who they are.

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

As for the virus, some things increase your risk of dying from it, such as being older and already having other health problems. And obesity is one of those health problems. You can't do anything about being older, but you can do something about being obese. Yes, it is neither simple nor easy - but you can do something. It's the same as all this frugality and savings we talk about here - some people can do a lot, some can do a bit, but everyone can improve their finances or health in some way.


But most people don't want to. Most people want to spend carelessly, and eat and drink carelessly. That's why most people are overweight or obese and in debt, however many public programmes there are. And the defensive response about comments about obesity is exactly the defensive response people have when someone comments about their credit card debts. "You don't understand..." Yes, we do understand, we've been there.


If I thought obese people didn't have value I wouldn't comment about it at all, I'd just stay quiet and let them kill themselves. I want obese people to live. I want 90 year olds in nursing homes to live. I want everyone to live. I wish that so many people were not so determined to kill themselves.


The solution to obesity is typically quite simple, but one shouldn't assume that this makes it easy.  For a great many people, it's one of the hardest things they've had to face.

Absolutely. It's hard and shitty.


It's also hard and shitty to go from being broke and in debt to having things together, to eventually being in a financially strong position. There are many obstacles. But success in this doesn't come from complaining, or pretending there's no problem, or bursting into tears when someone points out the problem. It comes from a sober assessment of things, to find where you can start making small improvements in your life.

With covid, the government nearly worldwide is full on taking unprecedented actions to preserve the safety of citizens. This is significantly more than a public health program. The equivalent response for obesity would be more akin to mandating which foods are healthy and then ordering all business/restaurants to no longer allow consumption and purchase of anything that is considered a risk factor for causing obesity.

A fair point. On the other hand, the public health programmes have been going for more than 50 years. You'd expect some result by now - but more people are obese than ever.


The equivalent response you suggest would not be tolerated in a democratic society. Just look at what happens when people suggest even a sugar tax (I don't think it'd be useful, but look at the responses). Even just saying that obesity makes you more likely to die from a respiratory disease causes much drama, as we've seen.



And again, compassion and empathy are completely compatible with a trolley problem of the type discussed here. If I see a speeding train hurtling towards a 90-year old and a 3-year-old and I can only save one, then all things being equal, I am going to save the 3-year-old. 100 times out of 100. That does not mean that I lack compassion, nor does it mean I don't believe the 90-year-old still retains their humanity. It's a simple weighing mechanism.

I don't think I could make that choice. But I could make the choice between 1 person and 5.

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1592 on: May 03, 2020, 08:09:52 PM »
The trolley problem isn’t applicable here because that deals with deciding between two irreversible decisions. In our case the economic fallout is reversible, but deaths are not. As I posted above, the death rate did not increase after the last recession, so I doubt there will be irreversible fallout unless our leaders are too lazy to act in the future.

Australia seems to be a unique situation in that the spread is well controlled and leaders aren’t willing to loosen very strict isolation orders. In the US the three sides are 1: Shut down until a vaccine is developed, regardless of cost - a fairly rare and extreme stance that’s probably just a straw man. 2: relax shutdowns once we have a plan in place to deal with the expected spike in cases. 3: reopen everything, otherwise people will die of starvation due to no job - also a straw man. Frankly I don’t think it’s responsible to open up people to possible irreversible death because hardly anyone in this country has their act together enough to weather a temporary lay-off. Yes it’ll cost a truck load of money to get these people through it, and many have good reasons for not having a cushion, but that’s what the government is for. We’ve been through this before, people. It was called the great depression. Except now with a plague.
« Last Edit: May 03, 2020, 08:15:10 PM by Abe »

Padonak

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Re: How long can we wait while flattening the curve?
« Reply #1593 on: May 03, 2020, 08:15:25 PM »
The trolley problem isn’t applicable here because that deals with deciding between two irreversible decisions. In our case the economic fallout is reversible, but deaths are not. As I posted above, the death rate did not increase after the last recession, so I doubt there will be irreversible fallout unless our leaders are too lazy to act in the future.

Deaths from the economic fallout are also irreversible.

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1594 on: May 03, 2020, 08:18:55 PM »
The trolley problem isn’t applicable here because that deals with deciding between two irreversible decisions. In our case the economic fallout is reversible, but deaths are not. As I posted above, the death rate did not increase after the last recession, so I doubt there will be irreversible fallout unless our leaders are too lazy to act in the future.

Deaths from the economic fallout are also irreversible.

Provide evidence of this occurring before. Citations please. I cited above (maybe before you joined the conversation) that in the US at least the death rates continued to decline well into the recession.

waltworks

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Re: How long can we wait while flattening the curve?
« Reply #1595 on: May 03, 2020, 08:30:55 PM »
You could make a reasonable argument that the "deaths of despair" crisis that was in the news for the last few years was at least partially a result of the great recession. I've seen estimates of 150,000 extra deaths/year in the United States.

I'm not sure how well the specific numbers of deaths there can be measured, though, nor exactly how many can be attributed to the recession itself rather than the long stagnation of wages/work since the 1970s or so for working class Americans.

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

-W


Abe

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Re: How long can we wait while flattening the curve?
« Reply #1596 on: May 03, 2020, 08:38:20 PM »
You could make a reasonable argument that the "deaths of despair" crisis that was in the news for the last few years was at least partially a result of the great recession. I've seen estimates of 150,000 extra deaths/year in the United States.

I'm not sure how well the specific numbers of deaths there can be measured, though, nor exactly how many can be attributed to the recession itself rather than the long stagnation of wages/work since the 1970s or so for working class Americans.

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

-W

Those started 9 years after the recession so it’d be hard to tie them to that specific event. Also, again, age-adjusted death rates continue to fall, not rise, in the US despite them. Secondly, that also assumes we do nothing (again) to mitigate the economic fallout. I would say those are not irreversible at this time, either on a personal level or societal level.

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1597 on: May 03, 2020, 09:07:52 PM »
So someone will have to provide data showing an increase in suicides if they’re going to use that as an argument against the lockdown
"Dear everyone, please save me the trouble of spending five minutes with google, because I thought maybe that when a person was sacked and broke they'd be happy."
Okay.

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

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

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

Oh and see figure 1 here - source 4

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

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

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

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

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

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

You are thus technically correct that there is weak evidence to suggest a small increase in deaths. But overall trends show no major difference. Also if we’re being utilitarian here, an excess 5k deaths would be 2 days worth from this epidemic. Please explain how this bolsters the argument of re-opening the economy without proper infection containment measures in place (not sure if that's your argument, sorry, it's hard to keep track of everyone).
« Last Edit: May 03, 2020, 10:00:49 PM by Abe »

Abe

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Re: How long can we wait while flattening the curve?
« Reply #1598 on: May 03, 2020, 10:03:37 PM »
The good news is that though no one has plateaued yet (0 deaths per day), most states seem to have reached a stable rate of daily deaths (the shoulder before the plateau). I do think we're getting close to reopening in the states that have good testing in place!

Kyle Schuant

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Re: How long can we wait while flattening the curve?
« Reply #1599 on: May 03, 2020, 10:29:52 PM »
Quote
Also if we’re being utilitarian here, an excess 5k deaths would be 2 days worth from this epidemic.
The US is not the whole world, you know mate.