Like with the death rate, I expect we'll seamlessly transition from "this isn't proof, in 2 weeks you'll see" to "this isn't news, everyone always believed that so it doesn't imply any changes in strategy".
Well, it isn't proof. It is evidence, though. And in two weeks, we will have a lot more evidence.
A lot of this is like Russian Roulette -- there's a huge amount about this virus which we don't know, and it could be super-bad or not-that-bad. It could also be there are bad and not-so-bad strains. Or it could be bad down-the-line.
Until we do have proof, I'm advocating being conservative. In 2 weeks, we'll know if people are turning up in ERs or in morgues. In a few months, we'll know about lung damage, immune system damage, strokes, or a lot of the other potential consequences. In a year, we'll know about vaccine and long-term immunity.
I think the key problem here is failure to understand risk management. I can believe one think, but act another way just in case I'm wrong. Or I can be unsure. And so on. That nuance is lost in the right/wrong discussions.
> A lot of this is like Russian Roulette -- there's a huge amount about this virus which we don't know, and it could be super-bad or not-that-bad.
I think at this point we know enough to say:
1) For most of the population, the virus is not that serious
2) For a subset of the population the virus is seriously deadly. For example, ~20% of NY state coronavirus deaths were from nursing homes, ~37% are 80 or older. By contrast, there were 2 people under the age of 10 at the time of this post. [0]
> I think the key problem here is failure to understand risk management
I think another key problem is a failure to be frank about the cost-benefit of our actions. I have had to make stronger cases about changing the color of a button or optimizing a backend call than I've seen presented by authorities who are shutting down or reopening or anywhere in between.
We don't know the virus is not serious for most of the population. We know most of the population won't die of it in 2-3 months. We have evidence of lung damage, increased risk of stroke, and a slew of other things which /are/ serious, and may impact a broader segment of the population.
We've redefined "serious" to mean in an ICU, on a ventilator, within a few weeks of catching it (or in some cases, we've defined "serious" to mean dead within a few weeks). By that definition, AIDS isn't serious for most of the population.
There is a distinct lack of ROI calculations, but my ROI calculations lean towards a much stricter shutdown than we have in place right now, together with thoughtful actions to protect the economy.
Unless your plan to deal with mortality in at-risk populations is to simply deny them medical care, then any plan which involves ignoring these populations and their use of extremely limited (in terms of the total population) medical resources is going to kill far more then the number implied by current COVID-19 mortality rates.
The estimate of 1% mortality is with medical intervention. The estimate of hospitalization rates ranges from 5% to 15% (sometimes higher). If you get a disease serious enough to require hospitalization, and there are no hospital beds/nurses/ventilators etc. available, then it is very likely you will die.
But of course it's worse then that: because hospital resources are generally somewhat fungible - at least for ICU/surgical treatment. So not only does your mortality shoot up to ~5% at least, literally every other treatable but potentially life endangering condition (say appendicitis - which occurs at a rate 1.1 per 1000 people per year, or an estimate of 300,000ish cases yearly in the US) has now become, quite likely, untreatable - and thus lethal (appendicitis will definitely kill you, untreated).
Lots of people seem really latched onto that 1% number or whatever they imagine it to be, without any actual consideration of the context of what that figure is actually all about, or you know, an explanation things are "not that bad" yet hospitals can't get PPE, and ventilator triage is in progress, and local morgue capacity has been overwhelmed.
On 1), what do you consider "not that serious"? IE, what are your metrics of choice, and what are the acceptable values?
Regarding the cost-benefit discussion, my perspective is that people only want to discuss the downsides from a reduced economy. Second order effects include reduced vehicle deaths, reduced deaths from pollution, etc. IE, my discussions has felt agenda driven because it considers first order effects only.
If we're going to compare apples-to-apples, I'm willing to have that conversation. If the conversation is limited to "people die during recessions", it's a pretty clear signal that agenda is driving and would not be a productive use of my time.
We are quite a lot of people that fear the operation will be successful but the patient is dead with the Corona actions being taken. Case in point, 26.5 million americans have sought unemployment benefits (https://vastuullisuusuutiset.fi/en/weben/women-bear-brunt-of...).
Your argument supports the statement that coronavirus is not as dangerous for young people compared to old people. And that it's really serious for old people.
There remains a required link to why this isn't serious for young people. And from there, an argument that this situation is better than the other scenarios (including 2nd order effects from other scenarios).
> Over 90% of the dead so far are old with comorbidites such as Hypertension and Diabetes
What's your definition of "old"?
I looked at your statista.com link and about 2/3 of deaths in NY are from people aged 75 and up. That leaves a non-trivial number of deaths for "middle-aged" people (and maybe younger).
Also, I don't know many middle-agers without some co-morbid condition, so I'm not sure we can just ascribe the deaths exclusively to "old sick people" because an enormous portion of the US population is "sick" with a morbid condition.
That being said, I will admit that there are many conflicting pieces of data flying about.
Are the PCR and antibody tests reliable enough to base our lock-down decisions?
Do we already have "herd immunity" and we're just too stupid/reluctant/lack-the-testing-capacity to realize it?
I have no clue. From my vantage-point it seems that most of us have our philosophical flags planted and we aren't willing to soberly assess where we are and maybe change our opinions.
It would be "nice" to have an AMA from an epidemiologist with expertise in this area to cut through the noise.
Coronary Heart Disease, Lung cancer and Hypertension can all be mitigated by a healthy life and the numbers seem to suggest that Corona has made these illnesses even more serious than before.
An AMA would be great and i can certainly see that being middle-aged with a co-morbid condition has gotten a lot more serious.
If I break both of your legs, that's serious. You're not dead.
If you catch AIDS, that's pretty serious. You're also not dead for a pretty long time.
If I poke your eyes out, that's serious. You're also not dead.
You've redefined a serious medical problem at one which kills you. COVID19 disables far more people than it kills. We don't know how many more, and we won't know for quite a while. With lung damage, most doctors believe the damage is permanent, but some believe people will recover in a decade or two. With other organ damage, we're just speculating.
If the argument is that more people will die from economic recession, it's a necessary component. What's the rationale for excluding it? Without 2nd order effects, it doesn't seem like the correct comparison.
As mentioned before, 20% of NY deaths are nursing home patients. 37% are 80 or older.
I'm on mobile and a bit lazy, but check out death rates for the flu in younger populations and compare them to this virus. The virus has a higher mortality rate but not enough to be worth worrying about in younger populations.
>Regarding the cost-benefit discussion, my perspective is that people only want to discuss the downsides from a reduced economy.
While keeping the benefits in mind is an important part of this analysis, the fact is the pre-quarantine deaths were already accepted as "worth it" given that there was no political will to reduce them.
But yes, we should tally the reduction in deaths, pollution, etc.
So 13k deaths in NY (so far) are under 80 years old. That sounds pretty dangerous to me.
Comparison to the flu could indicate that we underindex on all these other causes of death. It doesn't make those death numbers some magical line where now it's worth it, because Coronavirus deaths in 2 months equal annual flu deaths.
If you're adding everything up, please don't omit the costs of long-term disability from COVID19-related lung damage. That swings the numbers completely.
If it were just 3.6% of the US population dying, I would understand the economic versus public health argument. It comes down to values at that point: how much is a human life worth?
But that changes completely when you consider how many people we'll either need to support for decades, or who will have lower economic output. Those costs get astronomical, and at least by my ballpark estimates, align public health with economic outcomes completely.
A question for you: If you're so sure about the severity of the virus, then I'd like you to tell me what you know about the long term rammifcations of the virus on people that exhibit symptoms.
If you can't, then perhaps it might be a good idea to reconsider advocating for reopening the economy. Because for all we know, this could end up being another Chickenpox situation leading to something similar to Shingles. We don't know enough about the virus to make reckless remarks such as yours.
Generally speaking? it's probably a good idea to delay opening things back up until we know the full extent of the virus, yes. If the antibodies only confer short-term protection and people could get reinfected again (as some indications have shown), it MIGHT be a bad idea to reopen the economy and pave the way for a second wave of the virus, you know? Just throwing that out there.
If you think things are bad now, do you honestly think things would get better if we had to go through this again because we decided to stop early? Though given you seem to be peddling the idea that this is all a conspiracy by activists to keep us at home forever, I'm willing to bet you're not going to engage this point with any sort of good faith.
You say it's a conspiracy theory, but you agree we should stay at home until the "full extent of the virus" is known, and long-term effects by definition aren't going to be visible any time soon. Do you have a plan for how we could discover such things faster than a year or two?
I asked the OP to tell me what the long-term effects of the virus are given that they said for most of the population, the virus is not that serious. They haven't provided that information yet, so I'm going to assume they don't have it.
I do not have that information either. Until we (and 'we' as in medical professionals) figure out the best way to deal with the virus and any potential effects in the long term then yes, we should stay at home. Because there's still a lot of unknowns.
That's the position I would describe as "we should stay at home forever". I'm glad we could get onto the same page that my conspiracy theory was indeed true! When people in future conversations insist that your proposals are a strawman, I'll make sure to step in on your behalf, and explain that some people really do think we should be required to stay home for the indefinite future.
> If you can't, then perhaps it might be a good idea to reconsider advocating for reopening the economy.
Can you prove that coronavirus didn't give me protection from some other more severe illness a la cowpox and smallpox?
No?
We can both come up with creative scenarios.
We are severely impacting the quality of life of hundreds of millions of people. We should have a reason to do so grounded in fact and educated guesses.
What reason do we have to suspect your scenario? What are the odds that it will occur? What are the odds it's going to be severe? What's the anticipated quality of life impact and with what confidence intervals?
Also: even if it did create this situation, and we know it for sure, what can we do about it?
We don't have a vaccine. We don't have effective treatments. Those are potentially years away, if they ever materialize at all.
How long, and how severe, should a lockdown be to prevent a hypothetical scenario? What are the impacts of a quarantine that's long enough to guarantee a vaccine with, say, 90% confidence?
The major reason for suspecting long-term consequences were initially extrapolations from SARS and other related diseases. This was speculation. This was confirmed with chest x-rays in China: long-term lung scarring. People wrote this off, since it came from China. This was recently re-confirmed in Europe. Young people come off of COVID19 with reduced lung capacity.
What we should be doing is mitigating damage to those hundreds of millions of people. That's a lot easier to do than just about anything else in this equation.
The main reason why we are severely impacting the quality of life for millions of people is because our government is not willing to act to either provide some sort of basic income, supplies or guarantee survival for small businesses.
As I've mentioned in other posts here, we're remarkably lucky that COVID-19 isn't something currently far more threatening. Considering attitudes such as yours would easily lead to mass extinction as we strive to save an imaginary economy rather than the people.
As for how long and how severe a lockdown should be, I leave that up to the medical community. You and I are not part of that community and are not nearly educated to make that decision for them, so trying to argue that the economy must be opened up now is an argument made from ignorance.
The economy is not some magic genie that will give us what we want if we ask nicely. It is simply impossible to leave major sectors shut down for months. Most members of the medical community lack the necessary understanding of economics to make informed, rational trade-offs on this issue.
