Take the Shutdown Skeptics Seriously(theatlantic.com)
theatlantic.com
Take the Shutdown Skeptics Seriously
https://www.theatlantic.com/ideas/archive/2020/05/take-shutdown-skeptics-seriously/611419/
146 comments
My understanding is that overwhelming the health care system becomes easier the more spread the decease is. The real problem will be the lag in detecting the result of any public health measure with this virus. If only deaths can be measured the measurements will lag a few weeks potentially. With appropriate testing I guess the lag will still be a few days.
Now in the first wave you only had a few starting points as there were few sick people in few clusters. Today you have sick people all around the place. If the delay of measures are delayed in the second wave as much as in the first, the second wave will be much larger and it will be far less concentrated into clusters.
So this makes any policy change risky unless the measurement latency is very short. On top of this the impact of different policies is not known. So opening slowly makes it least somewhat scientific (understanding what works and what does not)
Of course the lockdown has a lot of negatives as well. I don't think many people dispute that. So it's a real a trade-off. But one that is very hard to get right because of all the unknowns, measurement latency (covid cases and side effects), and general emerging complexity of the problem.
On top of all this, this problem hits so many areas of public and private life. It's hard to nail down messaging to meet everybody.
So bottom line is it's hard to get right, therefore easy to criticize.
Now in the first wave you only had a few starting points as there were few sick people in few clusters. Today you have sick people all around the place. If the delay of measures are delayed in the second wave as much as in the first, the second wave will be much larger and it will be far less concentrated into clusters.
So this makes any policy change risky unless the measurement latency is very short. On top of this the impact of different policies is not known. So opening slowly makes it least somewhat scientific (understanding what works and what does not)
Of course the lockdown has a lot of negatives as well. I don't think many people dispute that. So it's a real a trade-off. But one that is very hard to get right because of all the unknowns, measurement latency (covid cases and side effects), and general emerging complexity of the problem.
On top of all this, this problem hits so many areas of public and private life. It's hard to nail down messaging to meet everybody.
So bottom line is it's hard to get right, therefore easy to criticize.
The initial goal was both to flatten the curve and to ramp up wide scale testing.
The federal government has largely failed in the latter, you can't reopen if you can't isolate and so we've wasted lots of the time that was gained.
The federal government has largely failed in the latter, you can't reopen if you can't isolate and so we've wasted lots of the time that was gained.
According to today's RealClearPolitics, the US has administered 9,444,525 tests, by far the most listed.
The second closest is Germany, with 2,755,770.
'Largely failed' doesn't seem fair.
https://www.realclearpolitics.com/
The second closest is Germany, with 2,755,770.
'Largely failed' doesn't seem fair.
https://www.realclearpolitics.com/
You can't use a total measure because it doesn't take into account the proportionality. It should be measured per 1M population. Germany is 32k to the US 25k.
https://www.worldometers.info/coronavirus/
We should probably also consider the number of tests in the most affected areas but I have no numbers on that.
https://www.worldometers.info/coronavirus/
We should probably also consider the number of tests in the most affected areas but I have no numbers on that.
They're all just winging it. The software model being used is garbage:
https://lockdownsceptics.org/code-review-of-fergusons-model/
The "Ferguson Model" is described here:
https://www.nature.com/articles/d41586-020-01003-6
https://lockdownsceptics.org/code-review-of-fergusons-model/
The "Ferguson Model" is described here:
https://www.nature.com/articles/d41586-020-01003-6
This model is not the only reason governments have acted. They also saw what happened in Wuhan, Italy, NYC, etc.
Also, the US federal government doesn't use it, they use a model from UW: https://www.vox.com/future-perfect/2020/5/2/21241261/coronav...
Also, the US federal government doesn't use it, they use a model from UW: https://www.vox.com/future-perfect/2020/5/2/21241261/coronav...
But how applicable is the experience of Wuhan, Italy, NYC, etc to most of the US?
People who live in areas with low population density don't think they need to shut down just because areas with high population density are vulnerable to this outbreak.
If you want to convince them, you'll have to show them examples where communities like their own have been hit hard by the virus.
People who live in areas with low population density don't think they need to shut down just because areas with high population density are vulnerable to this outbreak.
If you want to convince them, you'll have to show them examples where communities like their own have been hit hard by the virus.
Is the UW model based on the Ferguson code or not? The article I cited says Microsoft is doing a rewrite of the Ferguson code, and the UW model is funded by Bill Gates' foundation, and we all know that Bill is closely connected to Microsoft.
Given that the UW model chronically underestimates the US death toll, can you explain the reasoning behind "we shouldn't trust the model, but also we should still reopen"?
The UW model can't be said to estimate or underestimate anything at all - it's just curve fitting and is being constantly updated because the moment they issue an update, it's immediately out of line with reality. And not just out of line but outside the uncertainty bounds too.
There's a review of the performance of the model and its updates here:
https://www.nationalreview.com/corner/coronavirus-pandemic-p...
There's a review of the performance of the model and its updates here:
https://www.nationalreview.com/corner/coronavirus-pandemic-p...
Just because it's junk science doesn't mean I have better scientific analyses at my disposal.
To summarize about the model:
1. It does not produce repeatable results given the same input data, due to bugs. "Averaging" the results is suggested.
2. The algorithm uses equations of unknown purpose and origin.
3. The source code is hidden from independent view.
Passing off the results of this model as "science" is risible.
1. It does not produce repeatable results given the same input data, due to bugs. "Averaging" the results is suggested.
2. The algorithm uses equations of unknown purpose and origin.
3. The source code is hidden from independent view.
Passing off the results of this model as "science" is risible.
> Passing off the results of this model as "science" is risible.
Unfortunately, that's been true for 90% plus of all the science to date on this pandemic :(
Reading some of these papers and thinking of how merciless I'd be if I were their peer reviewers... then seeing people treat them as absolute truth... it's depressing as hell.
Unfortunately, that's been true for 90% plus of all the science to date on this pandemic :(
Reading some of these papers and thinking of how merciless I'd be if I were their peer reviewers... then seeing people treat them as absolute truth... it's depressing as hell.
The scary thing about the comments on that review are the ones from people who are clearly academic scientists, claiming bugs don't matter because you can just average them out in the wash and professional developers aren't qualified to judge their code. This confusion between intentional pseudo-randomness and bugs seems to be widespread.
Almost all scientists don't understand how to code. Just, full stop, don't get it.
(I was one of the exceptions, and man, was that ever frustrating.)
(I was one of the exceptions, and man, was that ever frustrating.)
I think that you're smart enough to grok a slight nuance to point 1; it's a Monte Carlo simulation. Being non-repeatable and having to average results is part of the definition of the simulation.
All code is trash, but not all code is trash for all the same reasons.
All code is trash, but not all code is trash for all the same reasons.
The code isn't a Monte Carlo simulation if you read it. It just iterates until it's simulated every day of the epidemic with the input seeds and then outputs the results to a table. The results are then given exactly without any uncertainty bounds: to make it a Monte Carlo simulation is probably impossible given how slow it is.
I think the article author mentioned that just to show (s)he understands stochastic modelling. As can be seen from your comments and others, it's apparent some people/scientists either aren't reading the article properly at all, or have a massively wrong understanding of what Monte Carlo/stochastic modelling techniques really are.
I think the article author mentioned that just to show (s)he understands stochastic modelling. As can be seen from your comments and others, it's apparent some people/scientists either aren't reading the article properly at all, or have a massively wrong understanding of what Monte Carlo/stochastic modelling techniques really are.
The reason for its random behavior is not Monte Carlo, it's because of bugs in the program. Please read the article.
If you read further you would have seen that the bug was of limited duration (saved state from a PRNG), the model reproduced upon a second run (third from the start) and furthermore didn't effect the results since this is ensemble modeling. As a fellow Techer I expected that you would have read all the responses before passing judgement.
500000 deaths is realistic for UK with uncontrolled spread given that many recent studies indicate ~0.9% IFR. 500000 assumes 89% prevalence.
I can’t make sense of any of the virus or the response. The data (writ large) is a mess, response has been contradictory at all levels, nothing seems logical, the models aren’t open source, the rationale opaque, the secondary and third order social issues (according to popular media narrative) also completely bizarre, and what little ground truth I’ve been able to obtain is altogether a completely different reality.
I’m absolutely done with any and all media. When it mattered most (literally life and death) it was click bait, politics, and outright fakery.
There needs to obviously be a public health retrospective on this but also a policy and communication retro as well.
I want to read a book on WHAT ACTUALLY HAPPENED. I want people with subpoena power and a 500 page report. This whole thing has just been bizarre. I can’t help but feel like I’m being punked.
I’m absolutely done with any and all media. When it mattered most (literally life and death) it was click bait, politics, and outright fakery.
There needs to obviously be a public health retrospective on this but also a policy and communication retro as well.
I want to read a book on WHAT ACTUALLY HAPPENED. I want people with subpoena power and a 500 page report. This whole thing has just been bizarre. I can’t help but feel like I’m being punked.
I know _exactly_ how you feel. the only number I look at anymore is the one week average hospitalizations in my state. the projections have been wildly wrong, they remind me of 2016 political polls.
I've tuned out all other news pretty much, even HN is getting bizarrely disconnected from reality. see the comment wondering "has testing increased? I haven't read anything". this is getting crazy.
I've tuned out all other news pretty much, even HN is getting bizarrely disconnected from reality. see the comment wondering "has testing increased? I haven't read anything". this is getting crazy.
even HN is getting bizarrely disconnected from reality
Notice what gets downvoted.
Notice what gets downvoted.
There is sort of a Teflon approach to mainstream media which goes something like: contradiction is acceptable so long as the experts tell us so. And the experts include the WHO.
As we learn more about all of the factors that affect shelter-in-place, those goalposts are going to change. There’s nothing disturbing about it.
One problem: The curve hasn't actually flattened in some places. Those places should continue to encourage as few people out and about as possible.
So in a rapidly changing, novel situation never experienced before we should be held to the faulty reasoning of the past rather than adapting and changing plans to reach the best outcome?
"I think the same thing today as two days ago. It doesn't matter that aliens landed on earth in the meantime. That won't change my mind about aliens not existing."
"I think the same thing today as two days ago. It doesn't matter that aliens landed on earth in the meantime. That won't change my mind about aliens not existing."
Yes, original intent was to flatten the curve. However, as more people got sick, we learned that covid may cause permament damages on patients. Therefore if there is a way to prevent people from getting the diease at all, I think that is path we should follow . If not possible, we should still slow down the spread of the disease until vaccination efforts start to give results or we have better medication.
> we learned that covid may cause permament damages on patients
It stands to reason that a disease that outright kills 0.1-1% of the people infected also gets a fraction of people near death, which means it damages them hard enough that they almost die. This effect is entirely consistent with other diseases, for example non-covid19 pneumonia.
As of now we have not learned:
* What fraction of people develop long term effects.
* By age group.
* How do these effects compare with long term effects of other diseases, like influenza or influenza-triggered pneumonia.
* Do these effects heal over a period of time, say a few months?
It stands to reason that a disease that outright kills 0.1-1% of the people infected also gets a fraction of people near death, which means it damages them hard enough that they almost die. This effect is entirely consistent with other diseases, for example non-covid19 pneumonia.
As of now we have not learned:
* What fraction of people develop long term effects.
* By age group.
* How do these effects compare with long term effects of other diseases, like influenza or influenza-triggered pneumonia.
* Do these effects heal over a period of time, say a few months?
All of the above should (hopefully) improve with time: vaccination (which will take on the order of years and not weeks or months), more effective treatment, more learning about the disease and risk factors, more ventilators and PPE produced and more widespread testing.
The US is especially poorly suited to deal with a lot of people with a life-long debilitating illness from damaged lungs.
The US is especially poorly suited to deal with a lot of people with a life-long debilitating illness from damaged lungs.
It seems far simpler to maintain one blanket guideline ("stay at home") than multiple contradictory ones from region to region. And what do you do when a hospital does become overwhelmed? Re-instate shelter-in-place and change the guideline back?
> The original argument was to "flatten the curve" to prevent hospitals from becoming overwhelmed.
I don't think anyone sensible ever said "flatten the curve, and we're done!"
Flattening the curve was the first and most urgent step, to avoid the overwhelming of medical systems like what happened in northern Italy.
Quite a few countries took advantage of that time to ramp up testing. Certain ahem countries kinda squandered it.
I don't think anyone sensible ever said "flatten the curve, and we're done!"
Flattening the curve was the first and most urgent step, to avoid the overwhelming of medical systems like what happened in northern Italy.
Quite a few countries took advantage of that time to ramp up testing. Certain ahem countries kinda squandered it.
Public health is a constantly changing landscape made up of frequently shifting inputs and analysis. It’s only in recent decades that our desire for absolutes has really given people the idea that these things should be simple.
Every country on earth has to move the goalposts during a pandemic — this is a sign the system is still working.
Every country on earth has to move the goalposts during a pandemic — this is a sign the system is still working.
And now that we know more about the mortality rate, what comorbidities lead to a worse prognosis etc., models that project deaths, hospital stays and the capacity of the health service to cope have been refined.
That's not to mention that many places in rural America have no capacity to deal with a pandemic - just think about the hospital in the Netflix Pandemic documentary ...
That's not to mention that many places in rural America have no capacity to deal with a pandemic - just think about the hospital in the Netflix Pandemic documentary ...
But then you must provide additional economic support to those impacted accordingly, as you regulate public behavior through updates to public health orders.
Most countries are doing that.
The one-off $1,200 in the US is fairly unique.
The one-off $1,200 in the US is fairly unique.
Can you provide citations to which countries exactly you're referring to by the phrase "most countries?"
https://www.washingtonpost.com/world/europe/europe-seeks-to-...
> France, Germany, Denmark, Britain and others have decided to take over the payrolls of struggling companies, so that workers don’t get laid off. The hope is that by paying people to stay home, governments can slow the virus’s spread while also averting an economic depression.
> Since many European countries had similar social safety net programs already, albeit in far more limited form, the salary supports were relatively easy to expand, almost literally overnight in many places, amid widespread consensus. When they imposed their economically devastating lockdowns, countries were thus able to signal to workers that their livelihoods would remain intact and to businesses that they wouldn’t immediately implode.
> France, Germany, Denmark, Britain and others have decided to take over the payrolls of struggling companies, so that workers don’t get laid off. The hope is that by paying people to stay home, governments can slow the virus’s spread while also averting an economic depression.
> Since many European countries had similar social safety net programs already, albeit in far more limited form, the salary supports were relatively easy to expand, almost literally overnight in many places, amid widespread consensus. When they imposed their economically devastating lockdowns, countries were thus able to signal to workers that their livelihoods would remain intact and to businesses that they wouldn’t immediately implode.
> France, Germany, Denmark, Britain and others have decided to take over the payrolls of struggling companies
Didn't the US largely do this too, via a forgivable loan to companies?
Didn't the US largely do this too, via a forgivable loan to companies?
Sorta. It's only partially forgivable, the rules are complex, and it ran out of the first round of funds in under two weeks.
yongjik(2)
> Lately, the prevailing argument seems to be that we need to shelter in place because virus cases will increase if we don't. That was not the original justification. Of course cases will increase! The question ought to be, will they increase to the extent that they overwhelm hospital capacity?
But that was the original reasoning.
"Flattening the curve" is reducing the number of virus cases that happen. The number of cases of the virus will increase -- the number of PEOPLE with life-threatening or life-changing injuries will increase, if we don't reduce the number of people spreading the virus.
But that was the original reasoning.
"Flattening the curve" is reducing the number of virus cases that happen. The number of cases of the virus will increase -- the number of PEOPLE with life-threatening or life-changing injuries will increase, if we don't reduce the number of people spreading the virus.
> "Flattening the curve" is reducing the number of virus cases that happen.
No, that is absolutely incorrect. Flattening the curve was not intended to reduce the total number of cases. It was intended to reduce the rate at which those cases occurred, i.e. to spread them out over time, so that hospitals did not get overwhelmed. It is a rate limit.
In the long run, the only way to shrink the total number of cases is a vaccine.
No, that is absolutely incorrect. Flattening the curve was not intended to reduce the total number of cases. It was intended to reduce the rate at which those cases occurred, i.e. to spread them out over time, so that hospitals did not get overwhelmed. It is a rate limit.
In the long run, the only way to shrink the total number of cases is a vaccine.
Vaccine or extermination.
But extermination means no international travel, and a stronger lockdown. Which looks like it worked for NZ, but won't for the US.
But extermination means no international travel, and a stronger lockdown. Which looks like it worked for NZ, but won't for the US.
Its extremely frustrating how we continue to be lied to and continue to having moving goalposts.
There is a real question whether we should try to squash curve or let it spread.
I would rather squashing the curve, but I don't think we as Americans have the discipline to squash it.
There is a real question whether we should try to squash curve or let it spread.
I would rather squashing the curve, but I don't think we as Americans have the discipline to squash it.
[deleted]
Friedersdorf has a number of quotes concerning the impact of a long term shutdown (and/or recession). That doesn’t seem like the same thing as being a shutdown skeptic.
Part of the point of the safer at home orders is to buy time, not only to avoid oversubscription of hospitals but also for government to ramp up testing, protocols, contact tracing, and so on. Look at South Korea for how that can work.
Unfortunately the federal government has squandered the opportunity to plan, prepare, and implement at every step along the way. At the same time, the bulk of the push to open comes not from reasoned argument, but special interests. The protesters seen at state capitols are victims of fake news, astroturfing organizers, and disinformation campaigns.
That Friedersdorf doesn’t discuss those dynamics—at all—makes me lose a lot of respect for him. It’s just lazy both-sides journalism, where a contrarian viewpoint is taken up with very little justification, examination of the facts, or assignment of responsibility to important actors. Very disappointing to read this in The Atlantic considering so much of its coverage -has- been so good.
Part of the point of the safer at home orders is to buy time, not only to avoid oversubscription of hospitals but also for government to ramp up testing, protocols, contact tracing, and so on. Look at South Korea for how that can work.
Unfortunately the federal government has squandered the opportunity to plan, prepare, and implement at every step along the way. At the same time, the bulk of the push to open comes not from reasoned argument, but special interests. The protesters seen at state capitols are victims of fake news, astroturfing organizers, and disinformation campaigns.
That Friedersdorf doesn’t discuss those dynamics—at all—makes me lose a lot of respect for him. It’s just lazy both-sides journalism, where a contrarian viewpoint is taken up with very little justification, examination of the facts, or assignment of responsibility to important actors. Very disappointing to read this in The Atlantic considering so much of its coverage -has- been so good.
Without commenting on whether I agree or disagree with anything in the article itself, I do find the rhetorical sleight-of-hand curious: the writer is effectively asking the reader to "take the shutdown skeptics seriously" by articulating the same points that "shutdown skeptics" have made and that haven't been taken seriously.
Or, put another way: despite the prevarication, the author clearly _is_ a shutdown skeptic, of course they want shutdown skeptics to be taken seriously!
Or, put another way: despite the prevarication, the author clearly _is_ a shutdown skeptic, of course they want shutdown skeptics to be taken seriously!
There's still a valid point in there that we should take the underlying need seriously, not the proposed solution of reopening.
For example, a solution could be as simple as America financially supporting its citizens like other countries have done, reducing the desperation that's causing the pressure to reopen sooner than they likely know is safe. Don't make it a lesser of two evils choice in the first place.
Reminds me of something I read on here about assuming a strong man version of people's arguments instead of a straw man one. Maybe they're knowingly protesting because they believe those are the only choices they have.
For example, a solution could be as simple as America financially supporting its citizens like other countries have done, reducing the desperation that's causing the pressure to reopen sooner than they likely know is safe. Don't make it a lesser of two evils choice in the first place.
Reminds me of something I read on here about assuming a strong man version of people's arguments instead of a straw man one. Maybe they're knowingly protesting because they believe those are the only choices they have.
Last night reading about the Great Plague of London. The people of London would have starved to death but because the city bought grain. And the farmers in England continued to carry food to the city even though they weren't being paid.
The shutdown skeptics/deniers willfully fail to understand that if the pandemic is allowed to rage unchecked the economy will shut down as people panic. It's telling that at the same time that want indemnity for businesses and organizations that reopen. That's why I say it's willful.
The shutdown skeptics/deniers willfully fail to understand that if the pandemic is allowed to rage unchecked the economy will shut down as people panic. It's telling that at the same time that want indemnity for businesses and organizations that reopen. That's why I say it's willful.
> For example, a solution could be as simple as America financially supporting its citizens like other countries have done
Money is not nutritious when eaten.
Money is not nutritious when eaten.
I believe the parent's point is this: We need an economy that produces a certain amount of stuff - food, water, electricity, fuel, healthcare. We can't just make that stuff appear by moving or printing money, we have to actually produce the stuff.
Now, I know, that was the idea behind "critical infrastructure" - we had to keep those things running, even if we shut down everything else. But the longer we shut down, I suspect the more things we find that are critical. (Made up example: Water is critical, so water treatment is critical, so the chemicals used are critical, so the ingredients to manufacture them are critical, so certain kinds of mining are critical, so eventually mining machinery is critical.)
Now, I know, that was the idea behind "critical infrastructure" - we had to keep those things running, even if we shut down everything else. But the longer we shut down, I suspect the more things we find that are critical. (Made up example: Water is critical, so water treatment is critical, so the chemicals used are critical, so the ingredients to manufacture them are critical, so certain kinds of mining are critical, so eventually mining machinery is critical.)
It turns out the majority of things people work on are a critical and fragile component of the supply chain of an essential good or service.
> Money is not nutritious when eaten.
Neither is an empty cupboard, which a lack of money can lead to.
Neither is an empty cupboard, which a lack of money can lead to.
How exactly are you supposed to make the argument that somebody else's argument is valid without explaining that argument?
What you're asking for here is a basically a Tweet: “I mean, maybe they're not wrong.”
What you're asking for here is a basically a Tweet: “I mean, maybe they're not wrong.”
Is it really "someone else's argument" though?
If you change the framing a little bit there's no reason this article couldn't have been titled "We Should Start to Think About Ending the Shutdown" or something. But if it had been titled that, most people who don't already agree would just write it off immediately. It's clear the framing was chosen to appear more reasonable and neutral in order to target those a little more open-minded or on the fence, to sneak past the out-grouping that leads people to dismiss the other side instinctively. That's not even really a criticism, given how polarized and partisan political discourse is; it's smart rhetoric.
So to answer your question directly: you can explain the argument without uncritically recapitulating it. The latter is what this essay does, which is why I think the idea that it's "someone else's argument" is a front.
For comparison, this [1] article showed up here a while ago. The authors repeatedly made clear that they disagreed with the skeptics, that they had "consensus views", that they weren't trying to Trojan horse a contrarian argument in under the guise of a call for open-mindedness and debate. That essay has flaws, and maybe it's naive, but I got the genuine sense when reading it that the authors were being forthright and earnest. I think they succeeded at making the case for the validity and worthwhileness of someone else's argument without looking like they're endorsing it.
[1] https://www.statnews.com/2020/04/27/hear-scientists-differen...
If you change the framing a little bit there's no reason this article couldn't have been titled "We Should Start to Think About Ending the Shutdown" or something. But if it had been titled that, most people who don't already agree would just write it off immediately. It's clear the framing was chosen to appear more reasonable and neutral in order to target those a little more open-minded or on the fence, to sneak past the out-grouping that leads people to dismiss the other side instinctively. That's not even really a criticism, given how polarized and partisan political discourse is; it's smart rhetoric.
So to answer your question directly: you can explain the argument without uncritically recapitulating it. The latter is what this essay does, which is why I think the idea that it's "someone else's argument" is a front.
For comparison, this [1] article showed up here a while ago. The authors repeatedly made clear that they disagreed with the skeptics, that they had "consensus views", that they weren't trying to Trojan horse a contrarian argument in under the guise of a call for open-mindedness and debate. That essay has flaws, and maybe it's naive, but I got the genuine sense when reading it that the authors were being forthright and earnest. I think they succeeded at making the case for the validity and worthwhileness of someone else's argument without looking like they're endorsing it.
[1] https://www.statnews.com/2020/04/27/hear-scientists-differen...
The U.S. doesn't have to choose between total shutdown and total opening. Targeted opening is feasible.
The U.S. also doesn't have to choose between individual destitution and death of the vulnerable. Some combination of financial support covered by bonds with freezing debt collection of various categories would provide significant relief.
As in all macroeconomic challenges a combination of approaches is necessary.
The U.S. also doesn't have to choose between individual destitution and death of the vulnerable. Some combination of financial support covered by bonds with freezing debt collection of various categories would provide significant relief.
As in all macroeconomic challenges a combination of approaches is necessary.
Exactly. I think that a lot of “lockdown skeptics” are totally cool with a targeted and phased restriction lift-up that involves clear metrics on how and when each stage should proceed. But it all gets drowned out by people instantly resorting to “they are advocating for an instant lift-up of all restrictions, what a bunch of morons who don’t care for human lives” sort of arguments, as soon as they hear anything but a unanimous agreement with an indefinite lockdown.
The current policy for my county, state, and federal government is a targeted and phased restriction lift-up, that involves metrics that unclear because we don't really know enough yet.
You might want to re-evaluate the "lockdown skeptics" arguments in that light.
You might want to re-evaluate the "lockdown skeptics" arguments in that light.
>that involves metrics that unclear because we don't really know enough yet
Not knowing numbers is not the same as vague or unclear metrics. For example, saying "phase 3 will proceed once the hospital occupancy goes below 30%" doesn't qualify as vague in my book (numbers and such obviously made up by me). While we don't know when that happens, the metric itself is very clear and specific.
What kind of metrics does your county's lift-up plan use that are unclear just "because we don't really know enough yet"?
Not knowing numbers is not the same as vague or unclear metrics. For example, saying "phase 3 will proceed once the hospital occupancy goes below 30%" doesn't qualify as vague in my book (numbers and such obviously made up by me). While we don't know when that happens, the metric itself is very clear and specific.
What kind of metrics does your county's lift-up plan use that are unclear just "because we don't really know enough yet"?
This entire discussion seems to miss the point that it is not black-and-white.
Every year, tens of thousands of people in the US die from influenza. But the economy is not shutdown to prevent this. We recognise that the cost of tens of millions of dollars per life saved is not worth it.
People seem to think it's morally bankrupt to put a cost on saving lives. But that is what we (as a society) do every day. Every healthcare system puts a price on each treatment. In the US the patient (or insurance) pays for it. In the UK an ethics council will determine if that is a good use of the finite money the system has.
But in order to have a proper discussion about this, we need to have some numbers. How many lives will be saved, how much will it cost? Is "lives saved" even the right metric? Any article that hand-waves away the numbers is worthless.
A thought experiment for both sides: at some point your opinion would change, for/against the lockdown. How much more or how much less deadly would COVID-19 have to be for you to change your mind?
Every year, tens of thousands of people in the US die from influenza. But the economy is not shutdown to prevent this. We recognise that the cost of tens of millions of dollars per life saved is not worth it.
People seem to think it's morally bankrupt to put a cost on saving lives. But that is what we (as a society) do every day. Every healthcare system puts a price on each treatment. In the US the patient (or insurance) pays for it. In the UK an ethics council will determine if that is a good use of the finite money the system has.
But in order to have a proper discussion about this, we need to have some numbers. How many lives will be saved, how much will it cost? Is "lives saved" even the right metric? Any article that hand-waves away the numbers is worthless.
A thought experiment for both sides: at some point your opinion would change, for/against the lockdown. How much more or how much less deadly would COVID-19 have to be for you to change your mind?
You're repeating the article with some grandiose hand-waving to compare it to the flu, when it's already killed 5x any flu season in just 4 months :/
Apologies for the pedantry, but whether you're looking at national (US) or international numbers, COVID-19 has killed "only" about as many people as a flu season. ~300k have died from COVID-19 in the world, which matches the WHO's estimate of 290k to 650k per year for the flu, and ~80k in the US almost exactly matches American numbers for the flu a couple of years ago [2]
[1] https://www.who.int/news-room/fact-sheets/detail/influenza-(...
[2] https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter...
Moreover, comparing the flu season to "just 4 months" is disingenuous. That's...roughly as long or even longer than what most people consider the flu season.
Of course, this is due to the lockdowns. I'm not trying to make the case that COVID-19 is "just a flu". we'd almost certainly be seeing much worse numbers if people weren't social distancing or whatever. And we're not finished yet.
[1] https://www.who.int/news-room/fact-sheets/detail/influenza-(...
[2] https://www.statnews.com/2018/09/26/cdc-us-flu-deaths-winter...
Moreover, comparing the flu season to "just 4 months" is disingenuous. That's...roughly as long or even longer than what most people consider the flu season.
Of course, this is due to the lockdowns. I'm not trying to make the case that COVID-19 is "just a flu". we'd almost certainly be seeing much worse numbers if people weren't social distancing or whatever. And we're not finished yet.
You are not counting flu and covid using the same methods, which is causing you to either undercount covid deaths or overcount flu deaths.
If you count covid and flu using the same method you see far more covid deaths.
Here for covid you're using "died after testing positive for covid", and for flu you're using "died after testing positive for flu or with presumed flu". You can see these are different.
If you count covid and flu using the same method you see far more covid deaths.
Here for covid you're using "died after testing positive for covid", and for flu you're using "died after testing positive for flu or with presumed flu". You can see these are different.
Sorry, I wasn't aware that I was doing that - I'm just using the official numbers I've got on hand. Can you provide any sources that provide an estimate that better lines up with the claim that COVID has "already killed 5x [more than] any flu season"?
I know that different states and countries are reporting COVID deaths differently. I've seen "shutdown skeptics" claim that the reason Belgium and New York and Sweden's official numbers look so bad is because of this: supposedly they're using a methodology closer to the one you claim is being used to source the flu numbers, unlike everyone else. So I don't think my official numbers are purely what you claim they are, but probably a mix of different methodologies. Even if on balance that's producing an undercount, do we have evidence for something like an undercount by a factor of five? The former I'd be happy to accept, the latter is a bit of an extraordinary claim and calls for the evidence to match.
Neither of my sources for the flu numbers say their number was derived in the way you're suggesting - the US one in particular says that it's an estimate using a statistical model rather than a count anything like what you're saying. Did I miss something in the sources?
I know that different states and countries are reporting COVID deaths differently. I've seen "shutdown skeptics" claim that the reason Belgium and New York and Sweden's official numbers look so bad is because of this: supposedly they're using a methodology closer to the one you claim is being used to source the flu numbers, unlike everyone else. So I don't think my official numbers are purely what you claim they are, but probably a mix of different methodologies. Even if on balance that's producing an undercount, do we have evidence for something like an undercount by a factor of five? The former I'd be happy to accept, the latter is a bit of an extraordinary claim and calls for the evidence to match.
Neither of my sources for the flu numbers say their number was derived in the way you're suggesting - the US one in particular says that it's an estimate using a statistical model rather than a count anything like what you're saying. Did I miss something in the sources?
The official numbers you have on hand are estimated using a ratio of deaths-to-hospitalizations [1] These official numbers are arrived at by _multiplying_ the number of flu death counts reported by various coefficients produced through complicated algorithms.
The coronavirus numbers are _not_ the result of multiplying the a death count, they are the death count that is muliplied to get the flu numbers.
You can find the observed flu death count for the last several years at https://www.cdc.gov/flu/about/burden/2017-2018.htm, but you have to dig a little on the page for each year - the pages are for giving "Estimated Influenza Illnesses" and describing that years model, and in the citations you can find the count of observed.
I'll come back and reply if I can make time to put together a spreadsheet with the observed counts per year with links.
[1] https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm#R... [2] https://blogs.scientificamerican.com/observations/comparing-... [3] https://aspe.hhs.gov/cdc-%E2%80%94-influenza-deaths-request-...
The coronavirus numbers are _not_ the result of multiplying the a death count, they are the death count that is muliplied to get the flu numbers.
You can find the observed flu death count for the last several years at https://www.cdc.gov/flu/about/burden/2017-2018.htm, but you have to dig a little on the page for each year - the pages are for giving "Estimated Influenza Illnesses" and describing that years model, and in the citations you can find the count of observed.
I'll come back and reply if I can make time to put together a spreadsheet with the observed counts per year with links.
[1] https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm#R... [2] https://blogs.scientificamerican.com/observations/comparing-... [3] https://aspe.hhs.gov/cdc-%E2%80%94-influenza-deaths-request-...
> the US one in particular says that it's an estimate using a statistical model rather than a count anything like what you're saying.
To count deaths you can either count only the people who had a test and were positive, or you can count deaths where the disease is listed on the death certificate as a cause or contributory factor, or you can use complex statistical modelling and look at excess all cause mortality. (positives deaths is lower than death certificates, which is lower than the statistical modelling).
Some countries further restrict the number given by testing. For example, the main number used in the UK during most of April was "was tested positive, died in hospital" -- they were not including care home deaths in that number. (They changed that in April so they now include care home deaths.)
Here's a Flu Report from the UK for the 2015-2016 season: https://assets.publishing.service.gov.uk/government/uploads/...
If you look at tables six and seven they give all cause excess mortality for the flu seasons between 2006/07 through to 2015/16 (It's a bit annoying that they've done it by flu season and not by year).
To count deaths you can either count only the people who had a test and were positive, or you can count deaths where the disease is listed on the death certificate as a cause or contributory factor, or you can use complex statistical modelling and look at excess all cause mortality. (positives deaths is lower than death certificates, which is lower than the statistical modelling).
Some countries further restrict the number given by testing. For example, the main number used in the UK during most of April was "was tested positive, died in hospital" -- they were not including care home deaths in that number. (They changed that in April so they now include care home deaths.)
Here's a Flu Report from the UK for the 2015-2016 season: https://assets.publishing.service.gov.uk/government/uploads/...
If you look at tables six and seven they give all cause excess mortality for the flu seasons between 2006/07 through to 2015/16 (It's a bit annoying that they've done it by flu season and not by year).
I don't think you read my comment at all.
Gotcha, in that case I think the point got lost in the mix. Would love to engage with it more though, seems like you're passionate and knowledgable about this.
The problem is you start by comparing this to the flu.
People are going to stop reading after that because it's generally a pattern of another idiot rambling.
Don't write in that pattern if you don't want people to interpret it in that pattern.
People are going to stop reading after that because it's generally a pattern of another idiot rambling.
Don't write in that pattern if you don't want people to interpret it in that pattern.
Yes judging from the responses that seems to be what happened.
Maybe I could compare it to car accidents - we don't ban driving because the costs would be enormous.
I hope that doesn't spawn replies about self-driving cars...
Maybe I could compare it to car accidents - we don't ban driving because the costs would be enormous.
I hope that doesn't spawn replies about self-driving cars...
Well, the difference between this and your examples is that it was a novel situation.
The question always comes to would you rather over react or under react to a novel pandemic?
It's also interesting that this conversation about economics isn't spreading more towards alright now that we have this lock down are there any monetary policy changes we can make to allow us to adapt to this?
Many other countries have dealt with the economic consequences of the lockdown better than the US, despite being poorer countries.
The question always comes to would you rather over react or under react to a novel pandemic?
It's also interesting that this conversation about economics isn't spreading more towards alright now that we have this lock down are there any monetary policy changes we can make to allow us to adapt to this?
Many other countries have dealt with the economic consequences of the lockdown better than the US, despite being poorer countries.
Hey, we love discussion on HN, we honestly want to hear more from you - but we try to avoid the sort of meta-conversations where people end up reading their interlocutors as a united opposition with strawman positions. You should totally reply to them with more info about what you're trying to say, they're probably being honest about being confused :)
> in just 4 months
Well, mostly in just 1 month—we entered April with around 5,000 US deaths, and exited it with over 60,000. So that's about 55,000 deaths in a single month.
Well, mostly in just 1 month—we entered April with around 5,000 US deaths, and exited it with over 60,000. So that's about 55,000 deaths in a single month.
First, when influenza spreads too much in some place, few schools are closed to control spread. Also, hospitals get closed to visits. Typically that is enough to get it under control.
Second, confirmed covid deaths already exceeded estimated influenza deaths. This is covid with lockdown and not finished yet versus influenza overall.
That is without comparing how long are you sick if you get sick and without comparing possible long term consequences of disease.
I mean, by the start of it influenza comparison made sense. At this point, it does not.
Second, confirmed covid deaths already exceeded estimated influenza deaths. This is covid with lockdown and not finished yet versus influenza overall.
That is without comparing how long are you sick if you get sick and without comparing possible long term consequences of disease.
I mean, by the start of it influenza comparison made sense. At this point, it does not.
But isn't this article very much presenting every nuanced piece of information as a black/white immutable fact?
The issue with comparing it with the flu is that people who are at an increased risk of serious complications have the vaccine made readily available to them - yes, each flu season there are spikes in cases, and deaths, and yes, some hospitals (especially in densely populated areas) struggle to cope - but it's kept somewhat at bay.
The flu vaccine is less effective some years than others (3 guesses per year, sometimes they guess wrong), and is definitely less effective in very old people, who have less of an immune system left. That's why the recommendation has shifted (in the US, other developed countries shifted longer ago) for everyone to get the vaccine, not just the people at risk of serious complications.
So I agree that there's no reason to compare COVID-19 with the flu, but your description of the vaccine doesn't appear to be that accurate.
So I agree that there's no reason to compare COVID-19 with the flu, but your description of the vaccine doesn't appear to be that accurate.
It is indeed less effective some years than others, which is when hospitals tend to suffer stress with usage levels.
As for very old people, yes, also true, but care givers are often immunised to decrease the risk to that population.
As for very old people, yes, also true, but care givers are often immunised to decrease the risk to that population.
There was an article that I saw yesterday, CBB to dig it up that said if only 80% of Americans wore masks we could nearly rid the country of corona virus.
That's all it takes. Such a simple thing. We can't have full re-opening while we have self-ish protesters who revel in spreading the disease and make a mockery of public health. If they'd have some personal responsibility or if stores would just take the initiative nationally to require masks for every patron, we'd be over this by fall, and subsequent waves wouldn't be so bad.
A post from someone in my hometown yesterday on facebook had a guy boycotting great clips because they made him put on a mask to step foot inside and he had to make an appointment. (State law now for all stylists/barbers/etc.). All it takes is respect of others AND the virus to stop this thing. Why can't people do this?
That's all it takes. Such a simple thing. We can't have full re-opening while we have self-ish protesters who revel in spreading the disease and make a mockery of public health. If they'd have some personal responsibility or if stores would just take the initiative nationally to require masks for every patron, we'd be over this by fall, and subsequent waves wouldn't be so bad.
A post from someone in my hometown yesterday on facebook had a guy boycotting great clips because they made him put on a mask to step foot inside and he had to make an appointment. (State law now for all stylists/barbers/etc.). All it takes is respect of others AND the virus to stop this thing. Why can't people do this?
No one can say masks would have that effect. Not enough evidence (yet?)
There's some evidence, and countries w/ mask culture seem to be doing better. It also has a psychological value of reminding yourself not to touch your face and reminding others that to keep distance. So, that could also be part of the reason it works, could be some placebo effects that add to the safety, but the fact is masks don't really protect the wearer because apparently stuff can come in through sides/and such but it protects others if you cough or sneeze, or just breath out droplets.
It's a combined effect that only works if it's got at least 80% compliance, preferably 100% should be required. Why take the risk of killing someone if the wearing a mask could alleviate it? Is wearing a mask such a horrible thing?
It's a combined effect that only works if it's got at least 80% compliance, preferably 100% should be required. Why take the risk of killing someone if the wearing a mask could alleviate it? Is wearing a mask such a horrible thing?
https://www.vanityfair.com/news/2020/05/masks-covid-19-infec...
> “One reason is that nearly everyone there is wearing a mask,” said De Kai, an American computer scientist with joint appointments at UC Berkeley’s International Computer Science Institute and at the Hong Kong University of Science and Technology. He is also the chief architect of an in-depth study, set to be released in the coming days, that suggests that every one of us should be wearing a mask—whether surgical or homemade, scarf or bandana—like they do in Japan and other countries, mostly in East Asia. This formula applies to President Donald Trump and Vice President Mike Pence (occasional mask refuseniks) as well as every other official who routinely interacts with people in public settings. Among the findings of their research paper, which the team plans to submit to a major journal: If 80% of a closed population were to don a mask, COVID-19 infection rates would statistically drop to approximately one twelfth the number of infections—compared to a live-virus population in which no one wore masks.
> “One reason is that nearly everyone there is wearing a mask,” said De Kai, an American computer scientist with joint appointments at UC Berkeley’s International Computer Science Institute and at the Hong Kong University of Science and Technology. He is also the chief architect of an in-depth study, set to be released in the coming days, that suggests that every one of us should be wearing a mask—whether surgical or homemade, scarf or bandana—like they do in Japan and other countries, mostly in East Asia. This formula applies to President Donald Trump and Vice President Mike Pence (occasional mask refuseniks) as well as every other official who routinely interacts with people in public settings. Among the findings of their research paper, which the team plans to submit to a major journal: If 80% of a closed population were to don a mask, COVID-19 infection rates would statistically drop to approximately one twelfth the number of infections—compared to a live-virus population in which no one wore masks.
Article in Vanity Fair about a computer scientist who plans on submitting a paper for peer review at some point in the future.
I wear a mask, but I have no illusions about how unsettled the science around doing so is.
I wear a mask, but I have no illusions about how unsettled the science around doing so is.
I agree there's a lot of misconceptions and myths about masks. It clearly is not a panacea, it's really difficult (or even impossible) to quantify the impact, especially when combined with other precautions. Plus there's very little research about how masks affect this particular virus, because it's always somewhat specific.
IMO the best thing we can do is look at experience from countries that managed to get the infection under control, like SK. I highly recommend these interviews with one of their leading experts, what he says makes a lot of sense:
https://www.youtube.com/watch?v=QwoNP9QWr4Y https://www.youtube.com/watch?v=gAk7aX5hksU
When he says face masks are one of the effective measures, I'd probably trust him ... The question is what exactly should be the rules.
Our country is in a lockdown for ~2 months now, and most of the time face masks were required when leaving the house. We're probably going to relax the rules a bit soon, only requiring them when closed spaced, etc. Which probably makes sense, it's pointless to wear a mask when jogging alone in the woods, or something like that (and people were not following that perfectly anyway).
My personal opinion is that face masks do help, partly because they limit how far your droplets reach, partly because it limits how frequently you touch your face. Even a simple home-made mask or scarf will help with that.
I think a lot of the "do not wear masks" recommendations in many countries is due to concerns that a recommendation to wear a face mask would make the shortage even worse.
IMO the best thing we can do is look at experience from countries that managed to get the infection under control, like SK. I highly recommend these interviews with one of their leading experts, what he says makes a lot of sense:
https://www.youtube.com/watch?v=QwoNP9QWr4Y https://www.youtube.com/watch?v=gAk7aX5hksU
When he says face masks are one of the effective measures, I'd probably trust him ... The question is what exactly should be the rules.
Our country is in a lockdown for ~2 months now, and most of the time face masks were required when leaving the house. We're probably going to relax the rules a bit soon, only requiring them when closed spaced, etc. Which probably makes sense, it's pointless to wear a mask when jogging alone in the woods, or something like that (and people were not following that perfectly anyway).
My personal opinion is that face masks do help, partly because they limit how far your droplets reach, partly because it limits how frequently you touch your face. Even a simple home-made mask or scarf will help with that.
I think a lot of the "do not wear masks" recommendations in many countries is due to concerns that a recommendation to wear a face mask would make the shortage even worse.
> IMO the best thing we can do is look at experience from countries that managed to get the infection under control,
What experience? You go on to recommend listening to an interview. I was hoping for data. Remember that we're discussing the suggestion in this pre-pre-preprint that we can be confident that wearing masks has a huge effect on the infection rate.
What experience? You go on to recommend listening to an interview. I was hoping for data. Remember that we're discussing the suggestion in this pre-pre-preprint that we can be confident that wearing masks has a huge effect on the infection rate.
I do not understand what is going on in US and in UK. Both have reached some plateau but the daily new cases are not going down. This has been going on for over a month.
I presume that this is result of too late reaction to the outbreak but perhaps somebody knows better.
I presume that this is result of too late reaction to the outbreak but perhaps somebody knows better.
You can safely ignore "new cases" as that is (and always was) a measure of testing capacity.
Look at: recorded deaths, excess deaths, hospital admissions, ICU admissions, serological studies.
Together they can give a good picture of what's happening.
Look at: recorded deaths, excess deaths, hospital admissions, ICU admissions, serological studies.
Together they can give a good picture of what's happening.
> Look at: recorded deaths, excess deaths, hospital admissions, ICU admissions, serological studies.
Please don't look at serological studies. Many of the serological studies have frighteningly high false-postive rates that can lead to faulty assumptions that 20% or 50% of people have been infected already. This pretty much isn't true anywhere.
Please don't look at serological studies. Many of the serological studies have frighteningly high false-postive rates that can lead to faulty assumptions that 20% or 50% of people have been infected already. This pretty much isn't true anywhere.
So long as you keep it in mind, it’s just statistics. There have been studies with both good and bad tests. The test itself is probably easier to compensate for in a confidence interval, than selection bias which is usually unknown.
The problem is that for most serological studies, a correctly calculated 90% confidence interval includes 0%.
That's not helpful.
That's not helpful.
Sero studies that take place where the expected result is <5% or where tests use sensitivity/specificty under 95% are indeed not helpful. But in those places perhaps it's too soon to even be doing sero studies. Look at hospital admissions there to track the evolution of the epidemic.
Once you have at least 10 or 20% immunity sero studies can be used with some confidence, and there are now a couple of tests that claim 98% or better sens/spec, so using the earlier poor ones should be avoided now.
Once you have at least 10 or 20% immunity sero studies can be used with some confidence, and there are now a couple of tests that claim 98% or better sens/spec, so using the earlier poor ones should be avoided now.
There are basically no (larger than a single building) places that can legitimately claim 5% or higher infection rates though, which is the point.
Several cities are comfortably over 10% now even with pessimistic estimates of immunity/IFR. NYC and Stockholm are two examples.
Even New York State as a whole is surely over 5% now.
Even New York State as a whole is surely over 5% now.
No they can't. You can browse my comment history for why. Tldr we'd need to see much higher positive rates among the viral tests to support that theory, and we don't.
I don’t understand. Not from your comment history either. What’s the problem disqualifying all studies? The Stockholm one is the one I’m most familiar with. It used a test with specificity over 98%.
Predictive power depends on the prevalence, but as the floor of immunity you can use any PCR study for active infection. In the case of Stockholm there was 2.5% active infection over a month before the sero study that showed 10%.
Obviously if a poor test with 85% or 90% specificity is used and you have low prevalence then you get a poor result. But if you can peg the floor of the prevalence at several percent and use an accurate test then what’s making the results useless?
But even disregarding sero studies, you can draw some conclusions of immunity from death numbers. E.g if assuming a 0.5% IFR with 1600 dead in 2100000 you would have 15% immunity (assuming everyone infected is immune of course). IFRs so high that they yield under 5% immune (basically IFR over 1.5%) aren’t consistent with observation.
Obviously if a poor test with 85% or 90% specificity is used and you have low prevalence then you get a poor result. But if you can peg the floor of the prevalence at several percent and use an accurate test then what’s making the results useless?
But even disregarding sero studies, you can draw some conclusions of immunity from death numbers. E.g if assuming a 0.5% IFR with 1600 dead in 2100000 you would have 15% immunity (assuming everyone infected is immune of course). IFRs so high that they yield under 5% immune (basically IFR over 1.5%) aren’t consistent with observation.
> IFRs so high that they yield under 5% immune (basically IFR over 1.5%) aren’t consistent with observation.
But they are. The IFR in places like China, South Korea, and NZ that have things mostly under control at this point, the CFR is consistently above 2% (and as high as 5%), and those places are and were doing significant viral testing, so wouldn't have missed 50% or 150% of the infected. So a CFR of 2% or 1.5% isn't unreasonable (unless you're relying on sero studies as "observation").
Unless you're assuming that there's a huge swath of people (like the significant majority) of Covid-19 cases that are entirely asymptomatic (and we don't have any reason to believe this, we have upper bounds on pre-symptomatic cases at like 50% from randomized viral presence studies, and the asymptomatic numbers should be notably lower), the IFR and CFR should be reasonably close, in places that have things under control and that makes 1.5% IFR more likely than .5%.
> In the case of Stockholm there was 2.5% active infection over a month before the sero study that showed 10%.
Source for this? Sweden has 26,322 confirmed cases today. You're saying that 24000 of those were confirmed in Stockholm well over a month ago?
But they are. The IFR in places like China, South Korea, and NZ that have things mostly under control at this point, the CFR is consistently above 2% (and as high as 5%), and those places are and were doing significant viral testing, so wouldn't have missed 50% or 150% of the infected. So a CFR of 2% or 1.5% isn't unreasonable (unless you're relying on sero studies as "observation").
Unless you're assuming that there's a huge swath of people (like the significant majority) of Covid-19 cases that are entirely asymptomatic (and we don't have any reason to believe this, we have upper bounds on pre-symptomatic cases at like 50% from randomized viral presence studies, and the asymptomatic numbers should be notably lower), the IFR and CFR should be reasonably close, in places that have things under control and that makes 1.5% IFR more likely than .5%.
> In the case of Stockholm there was 2.5% active infection over a month before the sero study that showed 10%.
Source for this? Sweden has 26,322 confirmed cases today. You're saying that 24000 of those were confirmed in Stockholm well over a month ago?
These are sampled PCR tests, the 2.5% was 18 positive in a sample or something like that. (https://www.folkhalsomyndigheten.se/contentassets/7bd5627f82...)
The same high specificity sero test that estimated 10% in the Stockholm pop., found 20% with antibodies among hospital staff in one hospital (https://lakartidningen.se/aktuellt/nyheter/2020/04/en-av-fem...)
> Unless you're assuming that there's a huge swath of people (like the significant majority) of Covid-19 cases that are entirely asymptomatic
I'm not. 50% sounds reasonable. But in Sweden, only people who are ill enough to be admitted to hospital have been tested so far (especially around the time of the earlier studies - now it's expanding to more general testing) and other than those it has been mostly hospital staff. So the missing number is all asymptomatic AND all the cases that aren't severe enough to require emergency care. And that's a significant number.
I thought there was a broad consensus now that is centering in on IFR of 0.3% in many places while others seem to have higher numbers like 0.5% or 0.8%. I haven’t seen many reports that suggest over 1%. CFR doesn’t really make any sense if you only ever confirm a fraction of the cases.
The same high specificity sero test that estimated 10% in the Stockholm pop., found 20% with antibodies among hospital staff in one hospital (https://lakartidningen.se/aktuellt/nyheter/2020/04/en-av-fem...)
> Unless you're assuming that there's a huge swath of people (like the significant majority) of Covid-19 cases that are entirely asymptomatic
I'm not. 50% sounds reasonable. But in Sweden, only people who are ill enough to be admitted to hospital have been tested so far (especially around the time of the earlier studies - now it's expanding to more general testing) and other than those it has been mostly hospital staff. So the missing number is all asymptomatic AND all the cases that aren't severe enough to require emergency care. And that's a significant number.
I thought there was a broad consensus now that is centering in on IFR of 0.3% in many places while others seem to have higher numbers like 0.5% or 0.8%. I haven’t seen many reports that suggest over 1%. CFR doesn’t really make any sense if you only ever confirm a fraction of the cases.
Or here's a study of NYC pregnant women (who were in hospital for delivery, not for coronavirus) that found 13.7% positive by PCR (not antibodies, active infection):
https://www.nejm.org/doi/full/10.1056/NEJMc2009316
Verity et al. estimated IFR around 0.6% back in March, based on stuff like the Diamond Princess, again no antibody tests:
https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
This is broadly consistent with the latest serology. NYC implies a bit worse if we divide excess deaths by antibody positives (though they haven't published their methodology as far as I know). Preprints from many European countries imply a bit better.
And ~0.2% of NYC is dead from coronavirus by now. So if less than 5% of the city has had it, you think IFR is >4% there? And you think NYC's announced serology data is ~15% false positives? Even though the total positive rate--which would include both true and false positives--in serology studies in most other cities (which haven't been hit nearly as hard as NYC) is far less than 15%? This makes no sense at all.
The simple explanation for Korea's high CFR is that for a disease where most countries have failed to trace ~100% of the cases, they're failing to trace about half. I think I've seen their public health authorities speculate exactly that, though I can't find the link now.
Inciting public panic is a different kind of harm from inciting public complacency, but it's harm nonetheless. I urge you to correct the misinformation you've posted above.
ETA: And really any single IFR is inherently misleading for this disease--the IFR climbs so steeply with age that it will vary greatly with population age structure, and with whether the disease disproportionately hits the most vulnerable (like when it spreads in nursing homes) or least (which should be our goal, since if we're unable to avoid herd immunity from recovered cases before a vaccine comes then that will cost the fewest deaths). But that's what was discussed above, so I stuck with it.
https://www.nejm.org/doi/full/10.1056/NEJMc2009316
Verity et al. estimated IFR around 0.6% back in March, based on stuff like the Diamond Princess, again no antibody tests:
https://www.thelancet.com/journals/laninf/article/PIIS1473-3...
This is broadly consistent with the latest serology. NYC implies a bit worse if we divide excess deaths by antibody positives (though they haven't published their methodology as far as I know). Preprints from many European countries imply a bit better.
And ~0.2% of NYC is dead from coronavirus by now. So if less than 5% of the city has had it, you think IFR is >4% there? And you think NYC's announced serology data is ~15% false positives? Even though the total positive rate--which would include both true and false positives--in serology studies in most other cities (which haven't been hit nearly as hard as NYC) is far less than 15%? This makes no sense at all.
The simple explanation for Korea's high CFR is that for a disease where most countries have failed to trace ~100% of the cases, they're failing to trace about half. I think I've seen their public health authorities speculate exactly that, though I can't find the link now.
Inciting public panic is a different kind of harm from inciting public complacency, but it's harm nonetheless. I urge you to correct the misinformation you've posted above.
ETA: And really any single IFR is inherently misleading for this disease--the IFR climbs so steeply with age that it will vary greatly with population age structure, and with whether the disease disproportionately hits the most vulnerable (like when it spreads in nursing homes) or least (which should be our goal, since if we're unable to avoid herd immunity from recovered cases before a vaccine comes then that will cost the fewest deaths). But that's what was discussed above, so I stuck with it.
Possible that it’s simply due to increased testing capacity. Before, many cases did not show up in the figures because there weren’t many tests carried out.
Are you sure testing capacity went up? I don't recall reading about that.
It's definitely up since early March. It's likely that testing capacity has been the limiting factor on case count for most of this time.
It’s very clear in the charts shown in the UK daily press conference. Positive tests in hospitals declining steadily, other tests (of which there has been a massive increase) making up the difference. What that says about what has actually been happening in the community is hard to say.
this is ridiculous, of course testing has gone up.
https://www.google.com/amp/s/www.wsj.com/amp/articles/corona...
pay attention to hospitalizations. that metric is disconnected from the new cases and expanded testing relationship.
https://www.google.com/amp/s/www.wsj.com/amp/articles/corona...
pay attention to hospitalizations. that metric is disconnected from the new cases and expanded testing relationship.
Percentage positive is disconnected from testing increases. It shows if you're catching more cases because you're testing more or if the true rate of infection is actually the same or decreasing. It still has sample bias - which depends on the availability and criteria for testing someone.
As soon as hospitals start allowing elective surgeries again hospitalizations become less of an indicator and you have to go by "suspected" or "confirmed tested" covid hospitalizations.
As soon as hospitals start allowing elective surgeries again hospitalizations become less of an indicator and you have to go by "suspected" or "confirmed tested" covid hospitalizations.
I don't think it's entirely disconnected.
It'd be disconnected if you had samples that are comparable (ideally random, representative of the population), but that's not the case in most countries. When you start with very limited testing capacity, you prioritize "important" groups of people that are often at higher risk of infection (healthcare workers, older people, ...) so you can expect higher percentage of people to test positive. But as you increase the capacity / number of tests, the sample structure will change - people with lower risk of infection will get tested, so it's natural to expect the percentage positive to decrease.
It'd be disconnected if you had samples that are comparable (ideally random, representative of the population), but that's not the case in most countries. When you start with very limited testing capacity, you prioritize "important" groups of people that are often at higher risk of infection (healthcare workers, older people, ...) so you can expect higher percentage of people to test positive. But as you increase the capacity / number of tests, the sample structure will change - people with lower risk of infection will get tested, so it's natural to expect the percentage positive to decrease.
Daily tests have increased over the last several weeks:
https://covidtracking.com/data/us-daily
Yes but the percentage of positive tests accounts for the increase in testing rates. Positive tests divided by total tests.
If percent positive of all tests is the same as before then the infection rate is not decreasing, or increasing - its constant. That is the case in many areas although some are seeing decreases or increases. E.g. some are increasing (e.g. Maine, South Dakota), some are decreasing (e.g. NYC, NJ), some are constant (e.g. DC/MD/VA have been constantly at 20% positive for the last couple of weeks now).
Most states are looking for a decreasing rate of positive tests for two weeks especially of its the percent positive case is under 10%. Generally under 10% is considered under control or manageable by experts.
If percent positive of all tests is the same as before then the infection rate is not decreasing, or increasing - its constant. That is the case in many areas although some are seeing decreases or increases. E.g. some are increasing (e.g. Maine, South Dakota), some are decreasing (e.g. NYC, NJ), some are constant (e.g. DC/MD/VA have been constantly at 20% positive for the last couple of weeks now).
Most states are looking for a decreasing rate of positive tests for two weeks especially of its the percent positive case is under 10%. Generally under 10% is considered under control or manageable by experts.
This isn't correct. Tests aren't given randomly. They're rationed and given only to the most at risk people. As testing capacity increases, tests can be given to groups who are less likely to be infected.
So at first tests were basically only given to people who had multiple symptoms, to be sure. Now you can get a test in my area if you're asymptomatic but working at a job that requires you to come into contact with other people.
If the percent positive of all tests is constant even as you test more people, that means that even as you test less obviously symptomatic people, the number of infected is constant, which could mean the infection rate is going up. Or not, but it's not certain that it's complex.
> Generally under 10% is considered under control or manageable by experts.
Can you cite this?
So at first tests were basically only given to people who had multiple symptoms, to be sure. Now you can get a test in my area if you're asymptomatic but working at a job that requires you to come into contact with other people.
If the percent positive of all tests is constant even as you test more people, that means that even as you test less obviously symptomatic people, the number of infected is constant, which could mean the infection rate is going up. Or not, but it's not certain that it's complex.
> Generally under 10% is considered under control or manageable by experts.
Can you cite this?
"There's no exact number to aim for, but here's a guiding principle: You want a low percentage of your tests to come back positive, around 10% or even lower, says William Hanage, an epidemiologist at Harvard."
https://www.npr.org/sections/health-shots/2020/04/22/8405263...
There are several other sources out there that state that for example the WHO also recommended it as a guideline. Yes not everyone is being tested but the 10% does account to some degree of the "severity" of those being tested. If you're only able to test the most likely cases you'll get a much higher % positive.
https://www.npr.org/sections/health-shots/2020/04/22/8405263...
There are several other sources out there that state that for example the WHO also recommended it as a guideline. Yes not everyone is being tested but the 10% does account to some degree of the "severity" of those being tested. If you're only able to test the most likely cases you'll get a much higher % positive.
That's an interesting question, and the answer is now discussed daily in most news conferences about the pandemic.
Asking interesting questions is good. Asking commonly answered questions is...
Asking interesting questions is good. Asking commonly answered questions is...
Testing capacity has gone up but in many places the percentage of positive cases - which accounts for the increase in testing - have stayed constant or even increased. For example in the DC/VA/MD area there has been a plateau of approximately 20% of tests positive for several weeks now which is a true indication that the infection rate is constant, not increasing or decreasing and accounts for the increased number of tests being done. NYC has definitely decreased its percentage positive in the last month, as have others, but plenty of other places in the US have seen increases or a plateau. You can find plenty of covid trackers that had the listing of total tests and total positive to determine this percent (e.g. https://covidtracking.com/data ). Generally epidemiologists, infectious disease control and other experts are saying under 10% positive is considered one good indicator that the infection rate is manageable and under control.
Hospital beds, like percent positive tests, are only one metric for determining health care capacity and how close we are to having an outbreak that overwhelms the all resources needed by the health care system to properly function. Globally there is a shortage of the medication used for sedating which is used when doing intubation or another medical procedure that requires sedation. Globally there is a shortage of PPE. PPE is at an extreme shortage globally still, and without PPE you have a shortage of medical workers (who then get sick or potentially spread it to other patients who aren't covid patients) - without health care workers those hospital beds become pretty useless. A lot of the initial cases in Wuhan came from cross exposure of non covid patients to covid patients at the hospital so canceling elective surgeries And mandating PPE made sense to prevent hospitals from becoming infection hotspots.
Why is everyone so hyper focused on hospital beds? They also literally canceled all elective surgeries as part of these stay at home orders which freed up something like 70% of beds that were being used. Additionally there aren’t as many trauma victims because car accidents, tourism, etc is down.
They know severity of cases and poor outcome when contracting the disease comes from initial viral load - being in close, confined places with someone who has it for a substantial period of time increases the severity of the disease. This is true for this virus and has mountains of evidence behind it in the study of virology to be true in general with viruses. It’s increasingly important here because the virus has no treatments in terms of medications, severe cases seem to be complex and the progression of the disease from this virus is not well understood. These guidelines and requirements for wearing a mask in public and need for health care worker PPE is a large part of the effort to help people have a less severe case of the disease if and when they do get exposed.
How myopic and superficial to not think about something more than hospital beds as a metric when evaluating these shutdown policies.
Hospital beds, like percent positive tests, are only one metric for determining health care capacity and how close we are to having an outbreak that overwhelms the all resources needed by the health care system to properly function. Globally there is a shortage of the medication used for sedating which is used when doing intubation or another medical procedure that requires sedation. Globally there is a shortage of PPE. PPE is at an extreme shortage globally still, and without PPE you have a shortage of medical workers (who then get sick or potentially spread it to other patients who aren't covid patients) - without health care workers those hospital beds become pretty useless. A lot of the initial cases in Wuhan came from cross exposure of non covid patients to covid patients at the hospital so canceling elective surgeries And mandating PPE made sense to prevent hospitals from becoming infection hotspots.
Why is everyone so hyper focused on hospital beds? They also literally canceled all elective surgeries as part of these stay at home orders which freed up something like 70% of beds that were being used. Additionally there aren’t as many trauma victims because car accidents, tourism, etc is down.
They know severity of cases and poor outcome when contracting the disease comes from initial viral load - being in close, confined places with someone who has it for a substantial period of time increases the severity of the disease. This is true for this virus and has mountains of evidence behind it in the study of virology to be true in general with viruses. It’s increasingly important here because the virus has no treatments in terms of medications, severe cases seem to be complex and the progression of the disease from this virus is not well understood. These guidelines and requirements for wearing a mask in public and need for health care worker PPE is a large part of the effort to help people have a less severe case of the disease if and when they do get exposed.
How myopic and superficial to not think about something more than hospital beds as a metric when evaluating these shutdown policies.
The UK government (or rather Public Health England) has basically lost control.
From tomorrow the devolved parliaments (certainly the Scottish government) will be diverging from tonight's confused "Stay Alert" messaging as announced by Boris. For at least the next three weeks the message in Scotland is still "Stay at Home".
From tomorrow the devolved parliaments (certainly the Scottish government) will be diverging from tonight's confused "Stay Alert" messaging as announced by Boris. For at least the next three weeks the message in Scotland is still "Stay at Home".
Keep in mind testing has been increasing the whole time.
I don't know about the UK, but what's happening in the US is that deaths in major cities are declining because the lockdowns are working, but cases and deaths are exploding in suburban and rural areas. The plateau right now is because those two effects are approximately canceling out, but as deaths in cities bottom out, total deaths will begin climbing again.
> deaths in major cities are declining because the lockdowns are working
I'm guessing it's because mitigations together with an increasing immunity is lowering the reproduction under 1.
In many large cities as many as 10 or 20% are now immune and that's a huge number if the theoretical herd immunity is somewhere around 60, and the practical one is somewhere even lower.
I'm guessing it's because mitigations together with an increasing immunity is lowering the reproduction under 1.
In many large cities as many as 10 or 20% are now immune and that's a huge number if the theoretical herd immunity is somewhere around 60, and the practical one is somewhere even lower.
Take the trucks with bodies seriously.
Take doctors deciding who to give the respirator to seriously.
Today facts don't matter as much. But I see these things and I remember this is only about 1% (maybe couple) of population getting sick already overwhelming the system and I don't need any more convincing.
Take doctors deciding who to give the respirator to seriously.
Today facts don't matter as much. But I see these things and I remember this is only about 1% (maybe couple) of population getting sick already overwhelming the system and I don't need any more convincing.
> Critics are dismayed. Citing forecasts that COVID-19 deaths could rise to 3,000 per day in June, they say that reopening without better defenses against infections is reckless.
The problem at this point is that there is little evidence that shutting down is improving our defenses. The federal effort is not there. The state efforts are haphazard. Worse, while the shutdown was strong enough to destroy the economy, it was enacted unevenly and poorly enforced so that transmission outside of the NY area has barely dropped at all. Without reducing transmissions significantly, there are simply too many cases and too little infrastructure to trace, test and quarantine.
The United States will likely serve as a cautionary tale for the rest of the world for a long time to come.
The problem at this point is that there is little evidence that shutting down is improving our defenses. The federal effort is not there. The state efforts are haphazard. Worse, while the shutdown was strong enough to destroy the economy, it was enacted unevenly and poorly enforced so that transmission outside of the NY area has barely dropped at all. Without reducing transmissions significantly, there are simply too many cases and too little infrastructure to trace, test and quarantine.
The United States will likely serve as a cautionary tale for the rest of the world for a long time to come.
I believe the US has been treated as a cautionary tale ever since January 20, 2017 ;)
Reminder to the professional class: Money is not nutritious when eaten. There is only so much that financial support can do when productivity and efficiency are slashed.
It may seem like everything will blow over if the Uber Eats fairy magically manifests food in exchange for currency at the homes of Americans, but for money to function there must also be productivity.
It may seem like everything will blow over if the Uber Eats fairy magically manifests food in exchange for currency at the homes of Americans, but for money to function there must also be productivity.
This article seems to have an odd relationship with nuanced facts.
While it is correct that nobody knows for sure how long it will take until medicine or vaccination are available, there are estimates that one can use for planning. But the article goes from "there is a level of uncertainty" to "impossible to know, let's ignore it completely".
Similarly, while the article is technically correct that the US is currently doing deficit spending, it really isn't the immutable fact that they present it as. It would be quite easy to levy taxes so that there's no deficit. Taxing the rich could finance the current level of stimulus spending for years, but the article goes from "we'll need to make adjustments to our system" to "it is impossible".
While it is correct that nobody knows for sure how long it will take until medicine or vaccination are available, there are estimates that one can use for planning. But the article goes from "there is a level of uncertainty" to "impossible to know, let's ignore it completely".
Similarly, while the article is technically correct that the US is currently doing deficit spending, it really isn't the immutable fact that they present it as. It would be quite easy to levy taxes so that there's no deficit. Taxing the rich could finance the current level of stimulus spending for years, but the article goes from "we'll need to make adjustments to our system" to "it is impossible".
Almost all these arguments have the same basic structure.
1. We depend on X 2. X is provided by free trade and the open market. 3. Quarantine hurts free trade and the open market. 4. Therefore, ongoing quarantine hurts X.
While the argument is sound, removing or reducing the quarantine (ie, solving point 3) is not the only solution. You can also change point 2, on a case by case basis, and remove the supply chain dependence on markets, money, profit, and capitalism.
Of course, someone who is "pro opening the economy" will be unable to accept this option on ideological or often self interest grounds, and thus try to reduce the option space to a simple binary, because mass death is better then the replacement of an economic paradigm from which they have benefited so.
1. We depend on X 2. X is provided by free trade and the open market. 3. Quarantine hurts free trade and the open market. 4. Therefore, ongoing quarantine hurts X.
While the argument is sound, removing or reducing the quarantine (ie, solving point 3) is not the only solution. You can also change point 2, on a case by case basis, and remove the supply chain dependence on markets, money, profit, and capitalism.
Of course, someone who is "pro opening the economy" will be unable to accept this option on ideological or often self interest grounds, and thus try to reduce the option space to a simple binary, because mass death is better then the replacement of an economic paradigm from which they have benefited so.
As a wise man once said - "If no one's making stuff, there won't be any stuff."
There's nothing to be taken seriously. These skeptics seem to be the equivalent of anti vax people. They read a couple bias confirming articles and studies and fill in the blanks for the rest of the argument. These skeptics aren't experts, they don't have all of the information. The continue to act enlightened. The internet has given a loud voice to minority. Why would I trust someone who has only just started to read about infections and policy over our actual leaders who are being briefed each day, working with real experts and getting constant data.
really this whole think just shows either lack of critical thinking and foresight or that there are a lot of sociopaths that can't have any empathy.
For anyone calling for the reopening of cities, even something like try it out and see (maybe this is better on this site, filled with engineers who don't just test stuff out live and see what happens) are you willing to die for this cause? Or are you willing to let a loved one die for this cause?
really this whole think just shows either lack of critical thinking and foresight or that there are a lot of sociopaths that can't have any empathy.
For anyone calling for the reopening of cities, even something like try it out and see (maybe this is better on this site, filled with engineers who don't just test stuff out live and see what happens) are you willing to die for this cause? Or are you willing to let a loved one die for this cause?
We are never going to "beat" the virus with lockdown restrictions. We could be in lockdown for two years, and the virus would still be there. We could try to hold out for a vaccine, but the optimistic estimate for a timescale is still on the order of a year or two. Meanwhile, the lockdown has real costs. Setting aside the direct economic effects (which I do believe are also important to consider), isolation and reduction of income cause real mental and physical health problems. At some point, the costs of the lockdown exceed the costs of the virus. I won't pretend to know exactly where that line is. The only real solution, in my mind, is to go for herd immunity as quickly as possible. That doesn't mean relaxing all restrictions, but it does mean tailoring the restrictions to maintain a high, but manageable case load in order to let the virus go through the population as quickly as possible without overwhelming medical systems. Of course, we should do our best to protect vulnerable people both to avoid unnecessary deaths and to limit the strain on health care. I believe the balance can be found, and as we learn more, we will be able to tailor our methods to control the virus while minimizing the impact on society.
I think the article is spot-on.
So far only .03% of the population of Sweden has died from Covid-19. (3.2k/10.2M). Pretty negligible. Does that really justify the consequences of shutting down the world economy?
Most of those people were going to be dying soon anyway. Like my grandma, she was 93.
I think we are experiencing the modern equivalent of China's disastrous "Great Leap Forward". But instead of being caused by terrified bureaucrats listening to a tyrant, this time it's from terrified politicians listening to the bleeding-heart media. The same folks that are always whining about something have now brought about the "Great Leap Backward".
One could say the world is now suffering under the tyranny of the media. Or rather, suffering the tyranny of the meek.
So far only .03% of the population of Sweden has died from Covid-19. (3.2k/10.2M). Pretty negligible. Does that really justify the consequences of shutting down the world economy?
Most of those people were going to be dying soon anyway. Like my grandma, she was 93.
I think we are experiencing the modern equivalent of China's disastrous "Great Leap Forward". But instead of being caused by terrified bureaucrats listening to a tyrant, this time it's from terrified politicians listening to the bleeding-heart media. The same folks that are always whining about something have now brought about the "Great Leap Backward".
One could say the world is now suffering under the tyranny of the media. Or rather, suffering the tyranny of the meek.
I think people overestimate how "open" Sweden really is. It's not particularly more open than many states, it's just that businesses and individuals have chosen to take individual responsibility to protect society[0], as opposed to fighting it as a danger to the economy and an infringement on rights.
[0]: https://www.theguardian.com/world/commentisfree/2020/apr/21/...
[0]: https://www.theguardian.com/world/commentisfree/2020/apr/21/...
Ok so look at Brazil, 11k dead out of 212M = .005%
It looks like you are just cherrypicking examples and wildly speculating. Brazil is early into this and seeing a high rate of transmission (R0 2.8). We really don't know enough in this country's case what the end result will be in terms of mortality.
>It looks like you are just cherrypicking examples and wildly speculating.
Hardly. Those are the two countries that have resisted shutdown of their economies and are showing negligible percentage of deaths.
And the World Food Programme has stated that the coronovirus shutdown is putting ~265 million at risk of famine and "as our Executive Director told the UN Security Council on Tuesday, we could be looking at 300,000 people dying every day for three months" [0]
>Brazil is early into this and seeing a high rate of transmission (R0 2.8). We really don't know enough in this country's case what the end result will be in terms of mortality.
Yeah. Perhaps it will bump up from .005% of their population dying to .03%. Mostly the already sick and elderly.
[0]:https://www.dw.com/en/world-food-program-act-now-to-prevent-...
Hardly. Those are the two countries that have resisted shutdown of their economies and are showing negligible percentage of deaths.
And the World Food Programme has stated that the coronovirus shutdown is putting ~265 million at risk of famine and "as our Executive Director told the UN Security Council on Tuesday, we could be looking at 300,000 people dying every day for three months" [0]
>Brazil is early into this and seeing a high rate of transmission (R0 2.8). We really don't know enough in this country's case what the end result will be in terms of mortality.
Yeah. Perhaps it will bump up from .005% of their population dying to .03%. Mostly the already sick and elderly.
[0]:https://www.dw.com/en/world-food-program-act-now-to-prevent-...
They reported 500 dead today, and 600 yesterday. Let's see where they are in a week or two (it'll be with 3x these death numbers and likely entering a lockdown de facto due to popular support for it).
>They reported 500 dead today, and 600 yesterday.
Brazil normally has 3800 deaths per day [0] so, as Bolsonaro says, so what. Some of the sick and elderly dying a few months earlier does not warrant removing the livelihoods of everyone else.
>Let's see where they are in a week or two (it'll be with 3x these death numbers and likely entering a lockdown de facto due to popular support for it).
Popular support is a function of media manipulation. And we know what types gravitate to that kind of work.
[0]:https://worldpopulationreview.com/countries/brazil-populatio...
Brazil normally has 3800 deaths per day [0] so, as Bolsonaro says, so what. Some of the sick and elderly dying a few months earlier does not warrant removing the livelihoods of everyone else.
>Let's see where they are in a week or two (it'll be with 3x these death numbers and likely entering a lockdown de facto due to popular support for it).
Popular support is a function of media manipulation. And we know what types gravitate to that kind of work.
[0]:https://worldpopulationreview.com/countries/brazil-populatio...
> And we know what types gravitate to that kind of work.
I have no clue what you're getting at, fwiw.
As for the meat of your comment, exponential growth hits like a truck. 1/3 of Brazil's confirmed Covid-19 cases were confirmed last week. In general that means the death rate, which lags infection rate by a week or so, is based on 100K infected, not 150K. So this time next week we'll see 1000 per day. The week after, 1500 per day, actually probably more as hospitals get overwhelmed.
> Some of the sick and elderly dying a few months earlier does not warrant removing the livelihoods of everyone else.
And what of the hundred plus people under thirty and the 1000 plus people under 60 who have died from covid-19 in Brazil so far? And the 100 plus people under thirty and the 1000 plus additional people under 60 who will die from covid-19 in Brazil in the next week?
I have no clue what you're getting at, fwiw.
As for the meat of your comment, exponential growth hits like a truck. 1/3 of Brazil's confirmed Covid-19 cases were confirmed last week. In general that means the death rate, which lags infection rate by a week or so, is based on 100K infected, not 150K. So this time next week we'll see 1000 per day. The week after, 1500 per day, actually probably more as hospitals get overwhelmed.
> Some of the sick and elderly dying a few months earlier does not warrant removing the livelihoods of everyone else.
And what of the hundred plus people under thirty and the 1000 plus people under 60 who have died from covid-19 in Brazil so far? And the 100 plus people under thirty and the 1000 plus additional people under 60 who will die from covid-19 in Brazil in the next week?
>> And we know what types gravitate to that kind of work.
>I have no clue what you're getting at, fwiw.
Basically the kind of people that on any given day (it switches to a new subject every few weeks) are whining(/bullying) about feminism, gay rights, misogyny, bullying, #metoo, etc etc are now causing the collapse of the world economy.
>As for the meat of your comment, exponential growth hits like a truck.
They say that but hasn't happened. And it's not like the virus is going disappear everywhere before the lockdowns need to be let up so there really is no point in having them in the first place. People just need to soldier on.
>And what of the hundred plus people under thirty and the 1000 plus people under 60 who have died from covid-19 in Brazil so far? And the 100 plus people under thirty and the 1000 plus additional people under 60 who will die from covid-19 in Brazil in the next week?
As shown in the previous link, 1 person net is added to the population of Brazil every 21 seconds. That's the real emergency.
>I have no clue what you're getting at, fwiw.
Basically the kind of people that on any given day (it switches to a new subject every few weeks) are whining(/bullying) about feminism, gay rights, misogyny, bullying, #metoo, etc etc are now causing the collapse of the world economy.
>As for the meat of your comment, exponential growth hits like a truck.
They say that but hasn't happened. And it's not like the virus is going disappear everywhere before the lockdowns need to be let up so there really is no point in having them in the first place. People just need to soldier on.
>And what of the hundred plus people under thirty and the 1000 plus people under 60 who have died from covid-19 in Brazil so far? And the 100 plus people under thirty and the 1000 plus additional people under 60 who will die from covid-19 in Brazil in the next week?
As shown in the previous link, 1 person net is added to the population of Brazil every 21 seconds. That's the real emergency.
> They say that but hasn't happened
It's happening right before your eyes: To repeat myself, 1/3 of Brazil's confirmed Covid-19 cases were confirmed last week. That's exponential growth. If that trend continues, and without intervention it will, a week from now, Brazil will be over 200K confirmed cases. A week later, well over 350K.
For comparison, Brazil is about where Italy was on March 20th. They had instituted a nationwide lockdown on March 9th, and still had peak deaths (at around 900/daily) a week later on the 27th and 28th. For brazil at this point, that's basically unavoidable.
So just checking, at what point do you believe a lockdown is reasonable? When covid causes more deaths than every other cause of death combined? Because that's just a month away.
> As shown in the previous link, 1 person net is added to the population of Brazil every 21 seconds. That's the real emergency.
I see no reason to consider this an emergency. If anything, we can expect the birth rate to begin decreasing as Brazil stabilizes. Of course that won't happen if a virus sweeps through and kills a bunch of people.
> Basically the kind of people that on any given day (it switches to a new subject every few weeks) are whining(/bullying) about feminism, gay rights, misogyny, bullying, #metoo, etc etc are now causing the collapse of the world economy.
I'm sorry you feel this way. I wish you happiness and peace in these hard times.
It's happening right before your eyes: To repeat myself, 1/3 of Brazil's confirmed Covid-19 cases were confirmed last week. That's exponential growth. If that trend continues, and without intervention it will, a week from now, Brazil will be over 200K confirmed cases. A week later, well over 350K.
For comparison, Brazil is about where Italy was on March 20th. They had instituted a nationwide lockdown on March 9th, and still had peak deaths (at around 900/daily) a week later on the 27th and 28th. For brazil at this point, that's basically unavoidable.
So just checking, at what point do you believe a lockdown is reasonable? When covid causes more deaths than every other cause of death combined? Because that's just a month away.
> As shown in the previous link, 1 person net is added to the population of Brazil every 21 seconds. That's the real emergency.
I see no reason to consider this an emergency. If anything, we can expect the birth rate to begin decreasing as Brazil stabilizes. Of course that won't happen if a virus sweeps through and kills a bunch of people.
> Basically the kind of people that on any given day (it switches to a new subject every few weeks) are whining(/bullying) about feminism, gay rights, misogyny, bullying, #metoo, etc etc are now causing the collapse of the world economy.
I'm sorry you feel this way. I wish you happiness and peace in these hard times.
>So just checking, at what point do you believe a lockdown is reasonable? When covid causes more deaths than every other cause of death combined? Because that's just a month away.
I think lockdowns of the entire population does more harm than good. I say protect the vulnerable and let the rest self-isolate if they feel the risk is warranted.
After all this ain't the Black Death plague, it's a bad cold that has a zero effect on most that get it.
Basically we've reverted to centralized control of the economy so it's failing like communism.
>>1 person net is added to the population of Brazil every 21 seconds. That's the real emergency.
>I see no reason to consider this an emergency.
It's an ecological emergency, take a look at the Amazon.
>I'm sorry you feel this way. I wish you happiness and peace in these hard times.
Yeah you're real smug working for Google aren't ya. Tell that to all the business owners, unemployed workers, and starving masses.
I think lockdowns of the entire population does more harm than good. I say protect the vulnerable and let the rest self-isolate if they feel the risk is warranted.
After all this ain't the Black Death plague, it's a bad cold that has a zero effect on most that get it.
Basically we've reverted to centralized control of the economy so it's failing like communism.
>>1 person net is added to the population of Brazil every 21 seconds. That's the real emergency.
>I see no reason to consider this an emergency.
It's an ecological emergency, take a look at the Amazon.
>I'm sorry you feel this way. I wish you happiness and peace in these hard times.
Yeah you're real smug working for Google aren't ya. Tell that to all the business owners, unemployed workers, and starving masses.
> Yeah you're real smug working for Google aren't ya. Tell that to all the business owners, unemployed workers, and starving masses.
If you feel the need to lash out at someone, I'm a better target than those facing more hardship. But yes, while I'm fortunate, I know many people who aren't in as stable a situation, most of them however recognize the necessity of that hardship.
It's an unfortunate situation yes, but the alternatives aren't better.
> After all this ain't the Black Death plague, it's a bad cold that has a zero effect on most that get it.
You're right, it's more like the Spanish flu, which killed 3% of the world's population at the time, or 180 million people today. That's not a sacrifice we should be willing to make.
> Basically we've reverted to centralized control of the economy so it's failing like communism.
No. This is comically incorrect. In some sense there is more centralized economic control sure, but well first of all that isn't communism, but second of all, that centralized control is succeeding at its goal, which is to reduce the death toll of the virus. You may not share the same value system, but that's Ok with most people, who don't value profit over lives. Granted this would be easier to bear for everyone if the US had a stronger social support system.
> It's an ecological emergency, take a look at the Amazon.
I don't see how deforestation in the amazon, which usually has to do with comsumerism in places like the US, has anything to do with the population of Brazil.
> I say protect the vulnerable and let the rest self-isolate if they feel the risk is warranted.
I read this as you saying you want some of the most vulnerable populations among us to sacrifice their safety and quality of life for the rest of us, while you yourself are unwilling to do the same for them. Is that correct?
If you feel the need to lash out at someone, I'm a better target than those facing more hardship. But yes, while I'm fortunate, I know many people who aren't in as stable a situation, most of them however recognize the necessity of that hardship.
It's an unfortunate situation yes, but the alternatives aren't better.
> After all this ain't the Black Death plague, it's a bad cold that has a zero effect on most that get it.
You're right, it's more like the Spanish flu, which killed 3% of the world's population at the time, or 180 million people today. That's not a sacrifice we should be willing to make.
> Basically we've reverted to centralized control of the economy so it's failing like communism.
No. This is comically incorrect. In some sense there is more centralized economic control sure, but well first of all that isn't communism, but second of all, that centralized control is succeeding at its goal, which is to reduce the death toll of the virus. You may not share the same value system, but that's Ok with most people, who don't value profit over lives. Granted this would be easier to bear for everyone if the US had a stronger social support system.
> It's an ecological emergency, take a look at the Amazon.
I don't see how deforestation in the amazon, which usually has to do with comsumerism in places like the US, has anything to do with the population of Brazil.
> I say protect the vulnerable and let the rest self-isolate if they feel the risk is warranted.
I read this as you saying you want some of the most vulnerable populations among us to sacrifice their safety and quality of life for the rest of us, while you yourself are unwilling to do the same for them. Is that correct?
>If you feel the need to lash out at someone.
People have to start speaking up against the overly politically-correct or we end up in situations like the current lock-down.
>It's an unfortunate situation yes, but the alternatives aren't better.
You can look at Sweden and see that is not true. Only .03% of population has died. That is 3% of 1%. [0]
It's not as if deadly flu's and other nasty diseases that people have to avoid naturally are not going around all the time anyway.
>You're right, it's more like the Spanish flu, which killed 3% of the world's population at the time, or 180 million people today. That's not a sacrifice we should be willing to make.
It's not killing 3% of the population. More like 3% of 1%.
~60M people die every year worldwide. Coronavirus barely moves the needle.
>I don't see how deforestation in the amazon, which usually has to do with consumerism in places like the US, has anything to do with the population of Brazil.
I live in the Amazon. Humans are like a plague of locusts, cutting down all trees and killing everything that moves. Deforestation is mainly from the poor doing slash and burn. And from people just trying to earn a living (the wrong way), more and more of them every day. (FWIW I'm here showing a better way. ie reforestation)
>So you want some of the most vulnerable populations among us to sacrifice their safety and quality of life for the rest of us? But you're unwilling to do the same for them? That feels rather selfish to me.
No I said protect the vulnerable and let the rest self-isolate if they feel the risk is warranted. As in, don't bring the virus into old folks homes.
You talk as if you think the common cold disappears after people hide in their houses for awhile.
And as if the world can go on shut down indefinitely.
Going on 8 wks of shut down here and it's a joke. Idiots copying the stupid.
[0]: https://www.worldometers.info/coronavirus/country/sweden/
People have to start speaking up against the overly politically-correct or we end up in situations like the current lock-down.
>It's an unfortunate situation yes, but the alternatives aren't better.
You can look at Sweden and see that is not true. Only .03% of population has died. That is 3% of 1%. [0]
It's not as if deadly flu's and other nasty diseases that people have to avoid naturally are not going around all the time anyway.
>You're right, it's more like the Spanish flu, which killed 3% of the world's population at the time, or 180 million people today. That's not a sacrifice we should be willing to make.
It's not killing 3% of the population. More like 3% of 1%.
~60M people die every year worldwide. Coronavirus barely moves the needle.
>I don't see how deforestation in the amazon, which usually has to do with consumerism in places like the US, has anything to do with the population of Brazil.
I live in the Amazon. Humans are like a plague of locusts, cutting down all trees and killing everything that moves. Deforestation is mainly from the poor doing slash and burn. And from people just trying to earn a living (the wrong way), more and more of them every day. (FWIW I'm here showing a better way. ie reforestation)
>So you want some of the most vulnerable populations among us to sacrifice their safety and quality of life for the rest of us? But you're unwilling to do the same for them? That feels rather selfish to me.
No I said protect the vulnerable and let the rest self-isolate if they feel the risk is warranted. As in, don't bring the virus into old folks homes.
You talk as if you think the common cold disappears after people hide in their houses for awhile.
And as if the world can go on shut down indefinitely.
Going on 8 wks of shut down here and it's a joke. Idiots copying the stupid.
[0]: https://www.worldometers.info/coronavirus/country/sweden/
> You can look at Sweden and see that is not true. Only .03% of population has died. That is 3% of 1%. [0]
The capitol of sweden is being hit as hard as NYC. And that's despite many social distancing measures in place. The idea that sweden isn't being impacted negatively is wishful thinking.
> It's not as if deadly flu's and other nasty diseases that people have to avoid naturally are not going around all the time anyway.
The resignation that shit's bad, so we should let it get worse is fatalistic and untenable.
> And as if the world can go on shut down indefinitely.
Indeed it can't, no one is proposing that.
The capitol of sweden is being hit as hard as NYC. And that's despite many social distancing measures in place. The idea that sweden isn't being impacted negatively is wishful thinking.
> It's not as if deadly flu's and other nasty diseases that people have to avoid naturally are not going around all the time anyway.
The resignation that shit's bad, so we should let it get worse is fatalistic and untenable.
> And as if the world can go on shut down indefinitely.
Indeed it can't, no one is proposing that.
> Denunciations of that sort cast the lockdown debate as a straightforward battle between a pro-human and a pro-economy camp. But the actual trade-offs are not straightforward.
The irony here is that these sentences are correct, but the author comes to exactly the wrong conclusion from them. There is no battle between a pro-human and pro-economy camp, because if we just threw the doors open and let the virus rage out of control, everyone would end up staying home out of fear anyway and there'd be no difference, in terms of economic damange, from a state-mandated shutdowns now. Note that there is nothing preventing you from flying right now, but the planes are still empty. Or how the government is ordering meat processing plants to reopen but they are still running way below capacity because workers are just staying home so they don't get sick.
It is not a choice between economic damage and lives lost, it's a choice between an orderly lockdown now and a chaotic de facto lockdown later, except the latter has a lot more people dying - the economic damage is inevitable either way.
Do not take shutdown skeptics seriously, they don't deserve it.
The irony here is that these sentences are correct, but the author comes to exactly the wrong conclusion from them. There is no battle between a pro-human and pro-economy camp, because if we just threw the doors open and let the virus rage out of control, everyone would end up staying home out of fear anyway and there'd be no difference, in terms of economic damange, from a state-mandated shutdowns now. Note that there is nothing preventing you from flying right now, but the planes are still empty. Or how the government is ordering meat processing plants to reopen but they are still running way below capacity because workers are just staying home so they don't get sick.
It is not a choice between economic damage and lives lost, it's a choice between an orderly lockdown now and a chaotic de facto lockdown later, except the latter has a lot more people dying - the economic damage is inevitable either way.
Do not take shutdown skeptics seriously, they don't deserve it.
That's not what the article says, though. It merely says that lockdowns do have consequences too, particularly prolonged ones, and we should consider those too. But such discussion is largely impossible because the whole issue got framed as good vs. evil, and even just questioning some aspects of the lockdown (say, school closures) gets you labeled as someone who essentially wants to murder vulnerable people.
FWIW I do live in a country which is in lockdown for ~2m now, and I do think it was the right thing to do. But it's not really feasible to stay in indefinite lockdown - not just because of economy, but because of impact on public health etc.
FWIW I do live in a country which is in lockdown for ~2m now, and I do think it was the right thing to do. But it's not really feasible to stay in indefinite lockdown - not just because of economy, but because of impact on public health etc.
The original argument was to "flatten the curve" to prevent hospitals from becoming overwhelmed. By that logic, areas where the hospitals have not been overwhelmed (which is most of the United States) should be gradually reducing restrictions, and only maintaining the restrictions necessary to prevent hospitals from becoming overwhelmed.
Lately, the prevailing argument seems to be that we need to shelter in place because virus cases will increase if we don't. That was not the original justification. Of course cases will increase! The question ought to be, will they increase to the extent that they overwhelm hospital capacity?
Most of the people quoted in the article agreed with shelter-in-place orders in the first place, and now they are being labeled as "skeptics" for sticking with the original rationale.