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We know it's deadly but not that deadly. The numbers from Korea, Italy and the Diamond princess are not good but they are not world-ending either. They are painful but that's it.

I am unclear on what you mean by "not that deadly". So let's discuss exactly how deadly we are talking about.

However https://www.thelancet.com/journals/laninf/article/PIIS1473-3... is a research paper published 2 days ago. Their median estimate for the infection fatality rate is 0.66%. Which, applied to the US population, suggests on the order of 2 million deaths. (More if everyone gets it, probably a bit less since only most of us would be likely to get it.)

If half the world population gets it, make that about 20 million. Or about a third of the total deaths in WW 2.

These kinds of evidence based numbers are rather worse than I would describe as, "...painful but that's it." But maybe your standards are different than mine.

> Their median estimate for the infection fatality rate is 0.66%. Which, applied to the US population, suggests on the order of 2 million deaths

3 million a year die in the U.S. each year anyway. How many of those 3 million will die of covid this year rather than cancer, or heart failure? Does that really matter?

Yes, it really matters.

How much does it matter? How much are you willing to spend to kill someone from cancer in July than kill someone from pneumonia in May?

The idea that every one of the millions dead from COVID-19 would've died anyways in the same year is... unsupported, to say the least.

The idea that many of them would have died anyways within a year or three is rather better supported, though. As is the idea that we need to run a cost-benefit analysis here.

See https://news.ycombinator.com/item?id=22751269 for a cost benefit analysis.

Long story short, it is worth it.

As with iso1631 there, I disagree. The lockdown will only save significant numbers of lives if it lasts until we have a way to reduce population death rates (either via better treatment, prophylactics, or vaccines) OR if we can exterminate it entirely and prevent COVID-19 from becoming endemic to the US again. I think the latter is unlikely, and the former requires 6+months of lockdown.

If we do three months of lockdown and then people give up and head out as normal again, we've burned a few trillion dollars, and a hundred million years of US citizen lives, for nothing. The deaths still come, just shifted back three months. That's the worst case, and it's what we might be heading for.

It should be entirely possible to ramp up masks and ventilators in a couple months. China is already making immense amounts.

Universal mask wearing would go a long way, especially with a much lower baseline of active infections.

There are far too many unknown, and indeed unknowable variables, for a cost-benefit analysis, even if it were politically acceptable.

There are broadly three options the US has

1) Total lockdown

2) Sporadic geographic lockdowns of various intenstiy

3) Do nothing

Factors we don't know include how behavior would change even without top down pressures (i.e. doing nothing will still damage economic output), and how long lockdowns can last before protests, riots, and full on civil war, how effective a lockdown would be, what pressure there will be on healthcare providers in each scenario (including say healthcare workers refusing to treat patients)

While our higher brains knows that as a society we are unwilling to spend $1 billion to extend someone's life by 2 days, when it comes to this sort of magnitude there are other considerations than financial benefits, indeed the entire situation brings questions of what is the value of money anyway. When we say we're willing to spend $150k to extend a life by a year, what does that actually mean?

Over $20.000.

I got that figure from http://content.time.com/time/health/article/0,8599,1808049,0... which suggests that a year of life should be worth about $130,000. So that is a bit over $10k per month.

Furthermore your hypothetical is slanted to minimizing the problem. Sure, these people are often old and sick. The median age of those killed is around 80. But they were Generally not on death’s door. From https://www.ssa.gov/oact/STATS/table4c6.html your average 80 year old has over 3 years to live. So we should be willing to spend at least $400k. Per life at the median. We are starting to talk about real money now.

But even so it is still low. Because the arithmetic average of this grizzly calculation is pulled up a lot by the younger people who die.

OK, I see you retort, so you’re coming to an order of a magnitude of a trillion dollars for the USA. But aren’t we doing more trillions in stimulus? Does that make sense?

The answer is yes. When we “spend” trillions in stimulus, we get most of it back. (In 2008 we actually made a profit.)

So even if you want to argue straight dollars and cents like an actuary does, we still come out ahead. Preserving human lives, even old people who do not have long to live, is valuable.

Lets say average life expectency of victims if they didn't have COVID is say 15 years.

Lets say 2 million would die without a lockdown.

That's 30 million years of life without a lockdown.

In the U.S. a year of life is under $150k, so that's an upper "value" of lockdown of $4.5T

U.S. GDP is 21T, so a 25% drop in GDP caused by a lockdown would not be value for money.

That is a good comparison point, and one I hadn't thought of.

Currently Goldman Sachs is estimating that next quarter will see production drop by 24%. If production drops for a single quarter by that much then rebounds, this is still worthwhile on that estimate. If it drops for a whole year by that much, you are right that the implicit value we are giving these lives is more than we are willing to pay to save lives in other circumstances.

This is an objective way to look about it. One important element missing is how much we'd have to pay in economic loss if we ended the lockdown today....

Just think about it. Will life simply return to normal with everybody going to beaches, stores, parks etc if they know the risks giving the new awareness of the disease? What I'm saying is that there is a high chance of a recession from the fear alone (not saying "irrational fear", simply "fear") as people will stay home and take fewer risks as they normally would, with the associated economic damage. Many will simply refuse to go back to an office.

So when calculating the savings from ending the lockdown, you have to take in consideration our losses from people's voluntary self-quarantine until the pandemic is effectively over if ending the lockdown prematurely.

Factors we don't know include how behavior would change even without top down pressures (i.e. doing nothing will still damage economic output), and how long lockdowns can last before protests, riots, and full on civil war, how effective a lockdown would be, what pressure there will be on healthcare providers in each scenario (including say healthcare workers refusing to treat patients)

There's also the subjective view - we aren't robots, people aren't objective automatons, many of us play the lottery for example, despite on average ending up behind, because we value the idea that we could get rich more than the value of the money we'd save not playing it.

There's then the relative weighting -- who suffers from that 25% fall in GDP? We may be willing to accept a 0.1% chance that someone in our close family will die in a car this year for $50k of personal gain, but we won't accept a 50% chance for "the economy" gaining $100m, of which $99m will go to "the 1%".

A crashing GDP affects "the 1%" more in financial terms than the majority. On the other hand with no cash to pay

There's then the value of a life. To me, my life and my family's life is far more important than yours. That's human nature. In the trolley problem where the choice is between killing their child and diverting it to kill 2 anonymous KKK members, almost everyone will divert it. Will a typical 25 year old with no family, a minimum wage job, and no health insurance, be willing to lose their home and live on the streets for the next 10 years in the unlikely save an 80 year old billionaire who doesn't care about them?

Good points. There are too many variables, and unknown changes to said variables for us to predict an optimal long term policy for handling this.

Thinking of it as objectively as I can, I can't see a scenario where the country keeps functioning well with the massive, rapid number of deaths associated with Covid-19. I know people die by the thousands in car accidents and other things. But at least in the short term, the widespread panic from a novel disease in ~2x/day geometric growth with 0.5-1.0% death rate (at best) would far exceed in severity anything we've ever seen.

Imagine Italy with no lockdown, would that be conducive to a healthy, or just mildly impacted economy? I don't see it. We had time to act, we didn't, now every option is bad, and now we're feeling the pain of the "less bad" option.

> Your car insurance might expire.

Do it online, or over the phone. (I just did!) New York is waiving things like annual car inspections and registration renewals, as well.

> Your heater might go down but there is no one to repair it.

Most of the shutdown implementations permit emergency repairs and grocery/medicine shopping.

> Do it online, or over the phone. (I just did!) New York is waiving things like annual car inspections and registration renewals, as well.

I live in a third-world. That's not an option. Insurance is waived for 2 weeks. But they just extended the confinement for 2 weeks more. How much are they going to keep waiving?

> Most of the shutdown implementations permit emergency repairs and grocery/medicine shopping.

These get disrupted because of the regulations/bureaucracies. Repairers now have to get a permit to go outside and drive. A simple grocery trip now takes 1.5-2 hours and lots of items are no longer available. This will get worse as the chain is pretty much disrupted at multiple levels.

> How much are they going to keep waiving?

This seems like a silly question. If they're already waiving, it's likely they'll continue to do so as long as the travel restrictions are in place. The first waiver seems like a pretty clear "we're not idiots" signal.

Not that you need car insurance if you're stuck at home...

> This will get worse as the chain is pretty much disrupted at multiple levels.

It's likely it'll get better as the initial supply shock eases and supply chains recover. It's not like we're all suddenly eating twice as much food - we just bought more than usual all at once.

insurance law nitpick: there are countries where not having an insurance active will cost you dearly just for that fact alone even if the car happily sits in a walled-off garage.

> Cabin fever (even though I'm an introvert and probably handling it better than most people out there).

This part has been interesting - I live alone, and have worked from home for a while, but it's still starting to get to me. I can't imagine people that live by themselves and are used to going to the office every day / are more extroverted.

They are going bonkers. I live in a small compound with gardens. I have a strict policy for not interacting with neighbors or not getting into their affairs (for lengthy reasons). A couple days ago I was about to call the police for what's possibly a bad fight/domestic violence for the neighbors next door. The neighbor above me had decided she wants to become a singer and now (as I am typing) is loudly signing. The one above that (second floor) is dropping kitchen object every other day and comes to collect/apologize for that.

This is fine.

Same for me, doing okay, but kinda getting to me. On the other hand, my partner is an extrovert and has cried multiple times saying "Imagine how you would feel if you were forced to go to a crowded party every day after work. I feel stressed and overwhelmed".

My wife and I argue [playfully, but still] about who gets to make a grocery run.

I'm the introverted one, so under normal circumstances I take any chance I get to stay at home. But I do get a certain kind of energy just from being around people in public, which is why I like grocery shopping.

> The numbers from Korea, Italy and the Diamond princess are not good but they are not world-ending either.

You lumped Korea and Italy together which is strange. Then apparently (seeing your comment chain) you tried to transpose it onto US and rest of the world.

Korea was ready (experience with previous outbreaks). They started early. They tested like there's no tomorrow and are still doing that. Test - isolate, test - isolate, test - isolate. Everybody wearing masks - negative, positive, or untested. Everybody [1]

And their health infra is impeccable. They are people with a great civic sense (I have lived there for months).

1. https://www.youtube.com/watch?v=gAk7aX5hksU

Perhaps we should be asking ourselves if our current system is flawed if have to choose to kill millions of people to keep the economy afloat. Certainly poor people will be greatly affected by the shutdown but to me that shows clear need for systematic change. Perhaps universal basic income isn't so wild an idea after all.

There's no number? So even if 90% of people were going to die you would be against a shutdown? Wat

If the virus killed 90%, we might actually do something about it. Like having everyone in a hazmat suit and do massive testing. Everybody will be going on about their life better than. Remember that some viruses (like Smallpox) kill at 30% and the world didn't have a shutdown but actually many wars through.

But because this is an opportunity for power grab by the government they'll much better prefer to have everyone confined rather than implement sanitary procedure and do massive testing.

Smallpox became endemic (https://en.wikipedia.org/wiki/Endemic_(epidemiology)) long before fast international travel. If a disease like it emerged today (high R0 factor, high mortality) we would absolutely need a shutdown.

> Like having everyone in a hazmat suit and do massive testing.

That'd require a shutdown in order to produce enough PPE and tests. Just like we're currently experiencing.

> If a disease like it emerged today (high R0 factor, high mortality) we would absolutely need a shutdown.

This is what worries me. This disease isn't as bad as it could be, but will reset expectations. Go in too hard and next time, with a similar disease but with a higher utilisation and it's a mess.

a smallpox analog now would break this world. covid-19 is a minor inconvenience in comparison. you've given me shivers just by making me think about it.