[HN Gopher] Questioning the Clampdown
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Questioning the Clampdown
Author : sbuttgereit
Score : 31 points
Date : 2020-03-18 16:04 UTC (6 hours ago)
(HTM) web link (www.wsj.com)
(TXT) w3m dump (www.wsj.com)
| ranprieur wrote:
| The number we need to know is the death rate in the absence of
| hospitalization. Because if we let it ride, and the hospitals
| fill up, that's the number we're looking at.
|
| If it turns out to be only 1%, then shutting down the economy is
| probably a mistake. But if it's more like 10%, then without
| quarantine we would get an economic collapse anyway, plus a much
| higher death toll.
| everybodyknows wrote:
| > death rate in the absence of hospitalization
|
| A reasonable proxy for that I suggest is the ICU rate from
| _Diamond Princess_ -- assume all ICU-severity cases die, and
| all normal hospitalization cases survive, under a tent in the
| hospital parking lot. About 4x DP fatality rate.
| greedo wrote:
| A 1% CFR will be catastrophic if we let it ride. Over 7 billion
| people worldwide. Assuming a simple 1% infection rate
| (extremely unlikely consider the R0 of SARS-CoV-2), that would
| result in over 700K dying worldwide. And that ignores the
| hospitalization required for non-fatal cases. Currently it
| looks like 18% of all infections require multi-week
| hospitalization. So again, with 1% infection rate, that means
| over 12 million hospitalizations. And that's just a 1%/1%/18%
| assumption.
| Gys wrote:
| A completely collapsed economy could trigger a society
| breakdown and will have deadly consequences as well, like
| violence (fighting over food, possesions) and bad healthcare
| greedo wrote:
| True. But imagine a more realistic scenario based on the
| CFR we've seen worldwide. Start with 7B people. Assume 50%
| get infected because we don't want to do a lockdown. 3.5B
| infections means 630M multi-week hospitalizations and 70M
| fatalities worldwide. And the follow-on effects will kill
| even more since these hospitalization rates will consume
| all our medical resources, so other illnesses will have
| higher CFRs as well.
|
| I don't know about you, but avoiding 70m fatalities and
| over 600M hospitalizations is the optimal choice. Pursuing
| this choice would be the greatest human calamity,
| surpassing the destruction of WW2 in terms of lives.
| tunesmith wrote:
| Is there a way to derive infection rate from the R0
| value? Because we don't even get close to 50% infection
| with the flu, and covid's R0 isn't like measles or
| anything.
| greedo wrote:
| We don't really have an accurate infection rate from the
| flu since we don't test for it. Most of the flu data is
| collected via surveys...
| SpicyLemonZest wrote:
| There's no way to derive infection rate at all,
| unfortunately. Even for pandemics in the past, where we
| can go back and look at all the epidemological data,
| estimates of infection rates tend to vary by at least 10
| percentage points.
| sbuttgereit wrote:
| I think this somewhat gets to the gist of the issue really.
|
| This virus is not the black death or the start of a zombie
| apocalypse. To a small percentage of people, getting this will
| be a really bad day and that percentage is higher than it is
| for viruses that similarly don't cause major health issues to
| most, but dramatically impact others.
|
| Having said that, the aforementioned small percentage IS enough
| to overwhelm the existing health care system and that alone
| would be enough to cause many, many of the more severely
| effected to die when they otherwise mightn't with proper care.
|
| So, having said all that I do, very wearily, agree largely with
| the lock-down measures in place. But I also think we're in a
| grey area between taking appropriate measures and overreacting.
|
| I think the article gets to another real issue. Many of our
| esteemed political leaders are selling this more like the black
| death/zombie apocalypse. Granted, most people I meet aren't so
| good with "nuance"; but overselling government responses to the
| virus to get compliance will create another, perhaps even
| worse, set of issues. Is the real impact of illnesses
| necessarily jeopardizing our supply chains? No. But the
| messaging is telling everybody that we're on the brink of
| societal collapse. So everyone is hoarding and living in fear
| that if they get it, they're all but dead. We may well be
| shutting down important businesses that are important, if not
| essential, and we're causing greater threats because of these
| artificial disruptions.
|
| I'm also worried longer term about what gets classed as this
| kind of emergency latter... for any number of civil liberties
| reasons. But I don't think the time is now to go call for a
| mass-protest on the steps of city hall either; though I expect
| that, due to this event, that day is closer than it was before
| the outbreak.
| taborj wrote:
| Very well written.
| egypturnash wrote:
| https://en.wikipedia.org/wiki/Holman_W._Jenkins_Jr.
|
| Born 1959. 61 years old.
|
| A quick search for covid mortality by age brings me to
| https://www.businessinsider.com/coronavirus-death-age-older-...
| which puts him in the 3.6% mortality bracket.
|
| If we assume his parents were in their twenties when they had
| him, they are in the 80+ bracket, with 14% mortality.
|
| As to what we are getting from this shutdown? Does "a major boost
| to Medicare For All and maybe even basic income to substitute for
| the fact that the minimum wage has not budged since 2009" count
| as a thing we get? Probably not, he got his already.
|
| Or in summation, ok boomer.
| dang wrote:
| You can't post personal attacks to HN, nor generational slurs,
| nor flamebait in general. We ban accounts that do these things.
|
| If you'd please review
| https://news.ycombinator.com/newsguidelines.html and use HN in
| its intended spirit, including right now when stress, fear, and
| anger are at higher than usual levels, we'd be grateful.
| cryoshon wrote:
| i've flagged this article for spreading dangerous misinformation
| regarding the ongoing public health efforts to curb the spread of
| the coronavirus. casually talking about discarding our only
| effective means of saving lives is unacceptable.
| jbob2000 wrote:
| Here's what it comes down to then; Which option is cheaper:
|
| 1. Spend money to temporarily increase hospital beds and
| ventilator capacity, but keep everything else running normally,
| or;
|
| 2. Shutdown everything to slow the spread so that we don't need
| to increase bed and ventilator capacity.
|
| I'm tempted to say that adding bed and ventilator capacity is
| cheaper. I don't think that option costs trillions of dollars,
| like option 2 does.
| rasz wrote:
| Cremona, Italy - not a single patient survived ventilation/ecmo
| to date https://www.youtube.com/watch?v=rfkbv_WQtn0
| steve_adams_86 wrote:
| But what if those medical resources aren't available yet? What
| if we need to wait weeks or months for them, no matter how much
| money we have to spend? If the entire world needs these things
| all at once, there is going to be a shortage (and there is).
| That's a death sentence for a lot of people, an overwhelmed
| medical system, and perhaps a runaway burden on the health
| system that no amount of dollars can catch up with.
|
| I think that's a large part of why we're shutting down. If this
| thing got away from us (we can't possibly know yet), a lack of
| isolation would mean every place that didn't isolate would
| essentially have an Italy situation on their hands. That's an
| insane risk to take.
| greedo wrote:
| The first assumes that increasing vents, ECMOs, and hospital
| beds is all that's needed. You'd still need trained staff to
| man them. Staff that is extremely vulnerable to this disease.
| Also, if you don't shut things down, you'll overwhelm the
| system, even if you were able to double the number of beds...
| jbob2000 wrote:
| Do those things cost trillions of dollars? I don't think so.
| Each country could probably commit a couple hundred million
| to this and be better off than a complete shutdown.
| greedo wrote:
| In a world with perfect planning, yes it would have made
| more sense for us to expand our healthcare so that we could
| withstand something like this. But we didn't. We made our
| bed, and we have to use what we have in hand.
|
| We can't create enough bed space, vents, ECMOs, in the next
| 6 months. We can't train enough doctors, nurses, etc in 6
| months. So we play the hand we're dealt, and choose a
| mitigation strategy that doesn't result in 70M worldwide
| fatalities (6M in the US).
| jbob2000 wrote:
| Why 6 months? How much money does it take to do it in 1
| month? Is that amount of money less than trillions of
| dollars?
| cayleyh wrote:
| It's not a cost issue. It's supply & capacity issue. You
| cannot create instant supply immediately, even with a
| trillion dollars.
| greedo wrote:
| It usually takes a doctor between 7-10 years to get
| licensed. Sure you can change requirements, but do you
| want someone just out of med school working in ICU
| without adequate supervision, making complex assessments
| and treatments? The pipeline for both nurses and doctors
| is just severely constrained.
| leggomylibro wrote:
| I believe that at this point, any quarantine or 'shelter in
| place' order must be voluntary. We stand to lose too much by
| giving up fundamental rights, and it is questionable what we
| would gain from...what, arresting the vanishingly small number of
| people who are still blase about the measures?
|
| Like the article notes, our goal is now to slow the virus, not
| stop it. Normalizing heavy-handed authoritarian measures will
| only breed future despotism.
| Supermancho wrote:
| > must be voluntary
|
| Must not be voluntary. Humans are erratic and generally
| selfish.
|
| > now to slow the virus, not stop it
|
| Stopping it is ideal and when the plague is leathal enough, the
| only option. It is not draconian to institute measures that are
| effective. They will be instituted eventually (eg if a plagie
| was ebola with a 60% mortality and 2wk incubation), regardless
| of what philosophy you subscribe to.
| thrill wrote:
| There's nothing voluntary when your boss is saying, "Well, I'll
| be at work - look forward to seeing you there".
| greedo wrote:
| Have you seen photos of large groups still hitting the bars?
| Lots of people think they're invulnerable.
| guenthert wrote:
| Not invulnerable, just not eager to give up their way of live
| and sanity for a stupid flu like sickness which they might or
| might not get. They are much more likely to die in a traffic
| accident when leaving the bar intoxicated, than from
| CORVID-19.
| deweller wrote:
| Please don't dismiss this illness. Your stated facts are
| not correct. One is 50 times more likely to die from
| CORVID-19 than a car crash.
|
| The latest CORVID-19 fatality rates for those aged 15 to 44
| is 0.5% [1].
|
| The odds of dying in a car crash in one year are 0.01% [2]
|
| [1] https://www.statnews.com/2020/03/16/lower-coronavirus-
| death-...
|
| [2] https://injuryfacts.nsc.org/all-injuries/preventable-
| death-o... - assumed 78 year lifespan
| p2detar wrote:
| Not to be picky, but those stats may be different for
| people that get intoxicated on a regular basis. Much like
| OP suggests.
| greedo wrote:
| It's COVID-19, not CORVID-19. And like your accuracy in
| spelling the disease, your facts are also poor and
| unsubstantiated.
| seemslegit wrote:
| Future despotism agrees.
| vearwhershuh wrote:
| Anyone concerned with individual rights should be concerned at
| the government responses. H1N1 caused 10K+ deaths and infected
| tens of millions in the US, and we had nothing even remotely
| approximating this response.
|
| This is not to say that we shouldn't be concerned and diligent in
| our efforts at containment, but that we should also be concerned
| and diligent about our liberty. Right now I see a lot of emphasis
| on the former and almost none on the latter, and anyone who
| voices concerns is labeled a crackpot or worse.
| rovolo wrote:
| The 10K+ deaths is over the entire course of H1N1/09. The US
| had ~4K deaths from 2009-04 to 2009-10 [1]. Italy has had 3K
| deaths in just 2020-03 [2]. You can't directly compare the
| early state of COVID-19 to the end state of H1N1/09.
|
| [1] https://www.cdc.gov/H1N1flu/estimates/April_February_13.htm
|
| [2] http://www.protezionecivile.gov.it/media-
| communication/press...
| SpicyLemonZest wrote:
| I think emphasis on the former is appropriate because the
| current measures are reasonably limited to the traditional
| scope of government disaster relief. Anti-gouging provisions,
| retooling factories to more socially useful goods, weeks-long
| shelter in place orders: all of these things regularly happen
| in response to disasters, although typically not simultaneously
| everywhere.
|
| I see some people talking about "oh, you know, we'll just have
| to ban social gatherings until 2021". If that happens - if the
| official conversation in a few weeks is about extending
| emergency measures rather than safe strategies for reopening
| bars - I expect people will get a lot more concerned and
| diligent.
| tunesmith wrote:
| I just googled that H1N1 had a fatality rate of 0.02% . Current
| estimates are that covid is 50x more deadly.
| akvadrako wrote:
| Not even H1N1 - annually about 500K people die of the flu and
| we don't even consider panic.
| iamaelephant wrote:
| This is a dangerously stupid article. Whether boomers like this
| author accept it or not we are finally living in a generation
| that ranks human suffering of higher importance than worshipping
| the S&P 500. Thank god for that.
| dang wrote:
| Please don't take HN threads further into flamewar. In
| particular: (1) don't call names; (2) don't post slurs
| ("boomers like this author").
|
| https://news.ycombinator.com/newsguidelines.html
|
| Edit: I've banned your account because you've been doing this
| repeatedly elsewhere. Please see
| https://news.ycombinator.com/item?id=22622252.
| underbluewaters wrote:
| I think it's healthy to question the efforts taken to deal with
| the virus. I'm not arguing for or against the quarantines, but
| I do think people need to be aware of the tradeoffs being made.
|
| To save the maximum number of lives will require shutting down
| a substantial portion of the economy for 18 months until a
| vaccine is ready for distribution. This could save more than 2
| million additional lives by recent estimates. There will also
| be substantial damage, and not just in terms of returns for
| shareholders. Livelihoods, retirement savings, and marriages
| will be destroyed. Lives will be taken by depression and
| unhealthy habits developed. This is going to be a very tough
| burden to bear.
| SubiculumCode wrote:
| This has received downvotes but is actually insightful. Without
| ethics and a focus on human value, we'd probably be forced to
| admit that a virus that removes the "unproductive" elderly for
| whom SS and Medicare expenses that are very expensive in normal
| times, and whose occupation of homes, often singly, inflate
| housing prices, etc etc, is actually a boon for the economy.
|
| Thank goodness that we realize that the economy is meant to
| support human value, not the other way around, else we'd let
| the "Boomer Remover" take its course.
| saurik wrote:
| Most of my friends--who aren't in tech, but are still better
| off than many--are now without jobs; soon they will not be able
| to afford food; if you are living paycheck to paycheck, you are
| already pretty screwed right now... like, I am seeing people
| begging for jobs on Facebook right now, so they can eat. If you
| are incapable of even having the discussion about whether 2% of
| people dying is better or worse than 25% of people going hungry
| for months, how can you make any claims about suffering? Our
| economy is unjust and unfair, but likening the existence of all
| of these jobs with some abstract number is "dangerously stupid"
| and kind of indicates you don't actually care at all about
| "human suffering". :/
| AlanYx wrote:
| This is really the crux of the matter. Discussions right now
| seem to be one-sided -- dominated by immediate
| epidemiological models of human harm -- but it may well be
| that the long term effects of massive prolonged unemployment
| ultimately cause more human harm, possibly even more deaths
| (due to depression, substance abuse and other illnesses of
| despair, secondary effects of crime, secondary effects of
| homelessness, possibly starvation/malnutrition in some parts
| of the world, etc.).
|
| I don't know what the answer is, but I hope that policymakers
| are weighing the big picture here and considering econometric
| models as well as immediate medical ones.
| seemslegit wrote:
| Given that boomers like this author are more vulnerable both to
| the disease and the S&P their risk calculus is more position-
| balanced then yours.
| tunesmith wrote:
| The last 24 hours have seen some dueling arguments, from
| respected sources, regarding how to model this.
|
| This one (pdf) has been highly influential to US and UK
| governments and is pretty sobering and alarming:
| https://www.imperial.ac.uk/media/imperial-college/medicine/s...
|
| This one is way on the other end:
| https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a...
|
| I'm just hoping that we discover effective treatments soon,
| because with those we might be able to start treating this like a
| normal cold before any of the worst case scenarios would come to
| pass.
| jtbayly wrote:
| That first link isn't loading for me. Looks overwhelmed. I
| checked the Wayback archive, and it says it has been archived a
| lot of times, but it isn't working. Anybody have a working
| link?
| allisonburtch wrote:
| the first link is a pdf. try checking your downloads folder?
| kasperni wrote:
| There is a summary of the imperial paper on Twitter
|
| https://twitter.com/jeremycyoung/status/1239976309456916482
|
| Not a very pleasant reading if people are hoping on a quick
| fix.
| neonate wrote:
| https://archive.md/KMBQc
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