99% of those who died from virus had other illness, Italy says

> We need to discard the destructive idea that isolating some subpopulation is a viable strategy in this epidemic.

Why? Tell me how long are you going to isolate everyone? Years? COVID-19 isn't disappearing after a month or two. It can flare up again.

> There's no place to isolate people but their homes, essentially. You either isolate everyone or you're going effectively no one.

This is a false dichotomy. You need to build herd immunity in the long run, otherwise you will have to isolate everyone indefinitely to prevent it from spreading again.

Of course herd immunity can be achieved by a vaccine, but a "generally considered safe" vaccine will likely take at least a year to materialize and then it is unclear how many people actually want to get it.

The idea that "it's just a flu" is still attractive in people's heads. People aren't good at estimating personal risk.

> Yeah, these are the deluded and despicable ideas going around. No, the economic cost of dealing with the massive death of any group would be huge.

Facts aren't "deluded or despicable". I'm just pointing it out. People over 70 generally are not economically productive, but they do cost a lot in terms of health care and social security, a lot of which is unfunded liabilities. Of course that's an uncomfortable fact, but that doesn't make it any less true.

Today this might be something that people are not comfortable pointing out, of course the ruling elite are essentially senior citizens. At some point though, the pitchforks are going to come out. That's what I'm warning you about.

I'll point out another fact: During the plague, Jews were big creditors. You can read up on what happened to them. If a crisis meets opportunity, morals go out the window. Count on it.

I'm not talking about "right now", I'm talking about long term.

> Also, letting the disease run rampant will not result in everybody above 70 somehow dying immediately, it will result in millions of people of all ages dying.

It's a simplification, obviously. People who have a severe infection and who are not treated will die pretty much immediately, however. In Italy, where the system already collapsed and no effective treatment is possible, the vast majority is over 70, younger cases else are outliers.

Of course some younger people will also die. The "people of all ages will die" narrative is important to keep people's attention up - but it's not going to work in the long run. The younger you are, the less likely you are to die, that's a fact. The younger you are, the less risk averse you, that's another fact.

> Compared to this, the risk to the economy, especially going by current measures (not Wuhan-style locked-in-your-home quarantine) is minimal.

That entirely depends on how long these measures are in place.

You don’t think a country where people wear masks to cope with the smog might have existing respiratory comorbidities?

I have not seen any studies that broke it down. The studies out of China only had patients self-report other conditions.

> Il numero medio di patologie osservate in questa popolazione è di 2.7 (mediana 2, Deviazione Standard 1.6)

It seems the above poses another question; is diabetes just confounding other underlying condition(s)?

Further, if most of the patients suffered from type 2 diabetes, it would likely correlate with older age in which case higher fatality rates are to be expected.

I was unable to find this info publicly available, but diabetes being one of the "2+ underlying conditions" seems probable.

There has been some speculation that it may not be the desease itself but the treatment that was the cause of increased risk.

Most people with high blood pressure also have some of those other comorbid conditions. But there are certainly cases of essential hypertension in otherwise healthy patients that have no clear cause.

Many people are asking the same question, also in the medical community. I wonder when we are going to see some data on this.

Article is paywalled for me. Will they take a ventilator off and away from say an 80 year old and give it to a 30 year old? In other words will they take ventilators away or will they leave them until a person recovers or dies?

Yes, but once the disease passes for them, they will be immune. Herd immunity is basically the only way this will pass away now, so we might as well be clever and push it on the side of the population that can take it.

EDIT: If we assume this is true and this will end when 40-50% of the population has already caught it, would it not be clever of us to make sure the 40-50% of the population that caught it is the one least affected by it? By making the measures the same for everyone you basically make sure the percentage affected will be uniformly distributed among all groups. If you make the measures distinct for each group, you tilt the odds in favour of one or another group, and might get a better outcome in the end.

IMO, now the people in power should balance several factors: - People in need of medical assistance - the group of people more likely to have permanent health effects from the infection - Economic impact of measures ( this, imo, can probably cause deaths in an indirect way as well) - population compliance to lock down measures (this will erode in time, I expect)

Ideally, the would find some social valve where they could play with the number of infected and they would direct this to the less at risk population and adjust the pressure over the medical system so it's just close to breaking, but not quite there, and directing the disease towards the least affected segment. Problem with this is the disease is not spreading linearly, so it's _very_ easy to loose this from under control. If they manage to make the status quo distanced enough so that the spread is more linear without disrupting too much the lives of normal people, and in the meantime playing with this valve for the less-at-risk population. If htis is feasible, I do nto know, but sounds like a reasonable idea.

Our quarantine has thus far been socially enforced, and quite effectively I might add. Schools are closed across the entire nation, despite the fact that children are the least likely age group to even express symptoms upon contracting coronavirus, let alone die from it. If the contagion is "spreading either way", why not allow people in the lowest risk groups continue on with our lives while we help the most vulnerable groups weather the storm from the safety of their homes?

That doesn't mean it's the wrong approach in general, just the wrong approach at this point in time.

In the short term, the curve needs to be flattened at (almost) any cost, while treatment and testing capacity ramps up.

In the long term, we need to gauge the risk and isolate more selectively. There is no way around herd immunity, we can't shut down almost everything for two years or more.

Another significant but hard to measure factor is virus load. A lot of otherwise healthy young healthcare workers are at elevated risk due to constant exposure and lots of stress.