I’m definitely in the camp that “the cure cannot be worse than the disease” itself. Sitting in California where there are so few cases makes me wonder if the economic toll is totally worth it. Seems like we’ve used a tsunami to put out a campfire.
I'm asking honestly for an explanation here, because you're certainly not alone in this view, but I haven't heard a rational justification for it yet, and I haven't been able to come up with one myself.
The correct figures to be comparing here are per capita deaths. Sweden is currently sitting at 1,014 deaths per 10M people while the United States is at 789. Ergo, Sweden's outbreak is roughly a third worse than the US so far, and growing worse.
This is probably true, but other countries haven't locked down hard and aren't seeing a big spread. Our options aren't binary. It's not as if the only choice is "Nuke everything" or "Surrender".
The US is not a very densely populated country, and density seems to have the biggest impact on the spread of this thing. We probably could do something like this:
- Dense city? Quarantine. - Moderately dense? High risk individuals quarantine, everyone else social distances, but works. - etc
Across the board, if your business is the sort that can WFH (such as software companies), then you do work from home. If not, then you're open, but with precautions. Restaurants are open, but pickup only, etc.
The point is, we've used a nuke, and it's not at all clear to me that that was the right decision.
Which countries might that be? If you're referring to South Korea, they're ahead of the game enough on testing for this to be workable (unlike us). If you're referring to anyone else, they're simply not at that point yet in the curve, but will arrive there.
The reason is actually NYC, specifically Cuomo and DiBlasio passing the buck back and forth and doing nothing. If you remove just NYC, the rest of the country is for the most part doing a lot better than Europe.
Both he and Cuomo took way too late to act, and now we're all suffering for it. Cuomo has since at least gotten better, but de Blasio has been terrible throughout.
[0] https://www.forbes.com/sites/davidnikel/2020/04/14/sweden-22...
The fact is Sweden has no full quarantine and they have less infection rates and less fatalities per capita than many countries with full quarantine.
It's clear that full quarantine may not be effective.
It should have less than Sweden if quarantine is effective.
In Sweden, there seem to have been only very few initial cases and the virus seems to be slow to spread there - it probably helps that Sweden is over 80% larger than the UK and has only 1/6 of the population. Also, at this time of the year it is much colder than the UK, less reason to be outside in big groups.
If you check the infection graphs, in the UK the quarantine finally seems to have an impact on the infection numbers, which stopped growing a while ago. Sweden still seems to have growing infection numbers.
Fortunately, we don't need to go to such extreme measures to get the replication rate below 1, but my point is, that extreme measures absolutely do work. The virus isn't magic; it needs to spread through relatively close personal contact. If you eliminate personal contact and sharing of spaces entirely, it cannot spread at all.
But is it more effective than simple washing hands and social distancing?
I think Sweden is proving that it's not.
Additionally short of what you're proposing...full total lockdown...the virus isn't going anywhere...it will be in society when we emerge from quarantine immunologically naeive ready for another wave of Corona.
Let’s be precise. Some other countries haven’t locked down hard and aren’t seeing a big spread yet.
You mentioned Sweden. Here was Time a few days ago:
> A head doctor at a major hospital in Sweden says the current approach will “probably end in a historical massacre.” He says healthcare workers at his hospital who have tested positive for the virus but are asymptomatic have been advised to continue working. He asked to remain anonymous because “it is frowned upon to speak of the epidemic or to go against the official vision” but said he felt a need to speak out from an “ethical and medical point of view.”
Personally I would call this “government irresponsibility”, but I guess we’ll find how it turns out within a few more weeks.
I’m not sure “have our cake and eat it to” is a good way to describe a crisis that is killing a whole lot of people and smashing the economy (in Sweden and many other places).
This approach absolutely infuriates me too, and it is the fault of "the government", but I am very curious what a more precise explanation is. Is it the current individuals in government? The ongoing culture within government? The broader culture of the country? Or maybe a mix of some of these, plus other things that I'm not able to perceive or imagine.
I bet we (humanity) could get get pretty close to the correct answer, if we made a collective and proper (easier said than done) effort to find out.
> A good first step would be for you to stop...
I have no hesitation whatsoever to admit that your approach may be correct, and mine incorrect, but I suspect this feeling is not mutual - is my intuition correct?
The problem (or more accurately, a problem) we have under our current form of democracy (in the US) is that we have an infinite number of variables that can be taken into consideration (and different people will select a different set for analysis), but we are only offered a single choice, with two options: Democrat or Republican.
I can respect your decision (analysis), and would be happy to devote literally hours to listening to your reasoning (I've extended such an offer in the past, as you may recall), but I suspect you don't feel the same way. Rather, it seems to me that you are determined to not like me, and accordingly, will look only at variables that support your conclusion, even if the values of those variables are absolutely incorrect (because they are based not on evidence, but rather speculation within your own mind).
In all of our conversations, you exhibit (so I perceive) extreme confidence and certainty in your beliefs, as well as an utter lack of concern (if not even realization of the very possibility) for the notion that you may not 100% correct in your beliefs - not just about me and my true beliefs, but also what is the necessary set of actions to achieve your (and my!) intended goals. If my perception is accurate, and if you are unwilling/unable to realize and rectify this situation, it seems reasonable that the consequences of this is that you will continue to have a highly flawed model of me in your mind.
I would recommend thinking of such ideas via mental experiments, such as: if one wrote software with such disregard for the importance of accurate analysis of reality, would you expect your program to function correctly? I suspect not. So why then would you expect different behavior when it comes to human and societal interactions? After all, are humans not in a sense extremely analogous to hardware that is executing software, all within a shared, interactive environment? I like to conceptualize humanity as a kind of MMORPG, not only because it's fun to look at it this way, but I think there is great utility in viewing things from a third person perspective, as it can often be helpful in achieving greater emotional separation from the situation, and therefore realize clearer thinking.
Furthermore, I speculate that if this sort of behavior is occurring at scale (across the broad population), the consequence may be that we may never be able to turn this ship around, and things will continue to get worse - ironically, bring about the very opposite of what your intended goal is!
Once again, I am putting a stake in the ground. Throwing down the gauntlet. I challenge you to engage in a proper conversation, with the goal (at least) of discovering what I really believe. I'm not asking that you agree with me, but only to face what my beliefs really are. Thus far, you[1] have been unwilling to engage in a serious, nuanced conversation, or even admit (consider?) that there could be value in such an exercise. You are free to do as you choose of course, as am I. I will continue to occasionally post comments from my perspective, and be open to proper discussion and challenges from all sides. If you choose to continue to respond with downvotes and inaccurate, hateful accusations, that is your right (although technically, it is very much counter to the HN Guidelines). And even though you may feel hate for me, and "people like me" (or so you subconsciously speculate), I will not feel hate for you, or people who hold beliefs similar to yours, because that road leads to hell.
[1] Actually, this is a bit harsh in that it could easily be interpreted as an assertion that you are unique in this regard. Rather, quite the opposite is true - it is my perception that I haven't encountered a single comment that has indicated a willingness to properly consider my fairly unique perspective. To be clear, this is not an assertion that all people on HN are in some way guilty of wrongdoing, but only that I have not encountered anyone "doing the right thing", for my definition of "the right thing" (dealing with this subset of reality honestly and ethically).
Let me know when you muster up courage proportional to your ego, and maybe we can have a discussion that consists of something more than insults and evasive tactics.
This is so untrue.
Norway and Denmark had initially many more cases then Sweden but since their curves flattened.
As of yesterday
Norway - 26 deaths / milion
Sweden - 102 deaths / million
Denmark - 52 deaths / milion
If you look at the huge drop in cardiac ER admissions it's clear that people are dying because they are having heart attacks and not going to hospital when they should. There's actually a severe problem with hospital underload right now. Governments, supposedly following the science, have built emergency field hospitals and shut down other medical work to protect hospitals that are now nearly empty. This was not predicted by anyone pushing lockdowns and is a grotesque mis-prediction with deadly consequences.
Nobody will talk about it at the moment, but I suspect when all this is studied in years to come the UK will be seen to have done worse partly because its population over-reacted to government extortions to "stay home, save the NHS". People are going to die just because they aren't going to hospitals they've been told they need to "protect" as some sort of moral mission. The NHS is often called a national religion, which isn't quite right - it's a religion to some and unfortunately those people aggressively attack anyone who points out what an institutional failure it is. It's easily believable that people will be avoiding hospitals in the UK in greater numbers than elsewhere right now.
We need to watch out for a lot of retroactive nonsense in the coming months. People will claim epidemiologists predicted all this (they didn't), that the lack of lockdown explains differing death rates (already disproven completely by the case of Sweden). Cold logic is all that will clear the fog.
Don't just drop a link, let's hear your real argument here.
Of the three people they mention in the article, two take buses.
There's not even an attempt to control. Are black judges living in Westchester statistically more likely than white judges living in Westchester to suffer more from the disease?
They have roughly an order of magnitude more deaths per million than Finland does (11.6 vs 99). We're somewhat locked down in Finland.
Look at the rate of growth for deaths per day (filtering out weekends because obviously swedes refuse to die on weekends)
Most places are seeing a plateau in number of daily deaths while Sweden is still growing exponentially
The US accepts 22k deaths a year without blinking due to flu. That’s just the flu. What’s the magic number we’re willing to accept? 50k? 100? There has to be a percentage of the population we are willing to accept as casualty because we already do, just unstated.
The lockdown will ultimately spread misery far and wide if left unchecked. Massive rise in poverty, violence, drug abuse, depression, crime, suicide, homelessness, prostitution, etc.
People need to be more clear on what they’re willing to accept. Right now there is no real discussion on “what next”. Lots of obsessing over the current body count though.
The US spends a lot of effort trying to convince people to get flu shots, take antivirals if they get sick, and stay away from vulnerable populations while contagious; hospitals prepare extensively for increased use during flu season (and medical workers are vaccinated, making flu much less personally risky for them), widely distribute easy-to-administer flu tests, treat people and keep them alive as best they can, etc. Estimated flu death numbers are also not comparable to current reported Covid death numbers, because they include a ton of guesswork, since many of the people who die while infected with flu officially succumb to some other condition (according to death certificates).
We don’t go into total economic lockdown for 2 months per year, because it would be impossible to enforce and extremely expensive, but we sure did during the last comparable pandemic, the 1918 flu.
Currently (and this will hopefully change as medical knowledge improves), Covid seems to be more than 10x more deadly than seasonal flu for most demographic groups. In an unchecked Covid epidemic (with hospitals overwhelmed) it appears that on the order of 1% of the population dies. (This has happened in some towns in Italy, where a very high percentage of the population was likely infected.)
> lockdown will ultimately spread misery
Having 1% of the entire population die within a matter of months is going to cause an extremely severe economic shock with or without official actions.
Anyway, I’m not sure we’ve overreacted. I’m just saying it’s possible and it’s pretty amazing how it’s hard to have a conversation about it. People treat the topic like there’s only one answer and anyone who dissents is a murderer.
I’m not calling you a murderer. I’m asking you to put a hard number in the risk you are willing to absorb.
Mine is 0.
To be perfectly fair, the current lockdown _IS_ going to kill people that would've survived otherwise. People that now won't go into emergency rooms out of fear of contracting Covid19, poor people whose source of income is completely dried out. And longer term, this is going to cost massive amounts of money, a fraction of which would of course be used to prolong someone's life in some way, eventually. I think the question raised in this thread is simply one of "what's the trade-off". It's very clear that there are costs to this lockdown, and at least to me it's also very clear that that some of those costs are human lives. However, we can't estimate those costs. We do have a guess of the rough fatality rate of covid19, and we do have models that will tell us how many people will die if we don't go into lockdown. But we don't have the same luxury for estimating the amount of people hurt and dead because of it that could otherwise be saved. We can quantify the monetary loss, but not how much of that loss would've otherwise gone towards saving lives. I think the question of "what are the human costs of this lockdown" is a fair one to ask. Don't get me wrong, I too think the lockdown makes sense and overall does save lifes. But the lockdown is not without risk, and even more importantly: I have not seen any estimate of the risk. Is it lower than 0.5-5% of the population? I think so, but both of us haven't done the math, so you talking down to people who ask about it is wrong.
You've got the blame all wrong here. These people that are dying who would've survived otherwise are directly being killed by the pandemic, not by the lockdown. If the pandemic were completely uncontained then the hospital system would be way more overwhelmed and you'd be much more likely to die of other causes for lack of healthcare. The lockdown is saving lives by helping to preserve healthcare resources so that if you have some other need like a heart attack there might still be a doctor free.
It's not like, if the lockdown weren't happening, then there wouldn't be a pandemic. What would happen is that the pandemic would be way way worse.
We are very, very far from political instability still. Let's not be alarmist.
Unfortunately the worst case death numbers for an uncontrolled pandemic crack into the millions in the US alone. That is, frankly, more deaths than anyone with a sound conscience is willing to accept.
Also, we have vaccines for the flu that significantly decrease your chance from dying of it. I get the vaccine every year. There's a big difference between being completely at the whim of a disease and being able to take proactive measures against it to help protect yourself. The only proactive measure that works against COVID-19 (which is much deadlier than the flu mind you) right now is social distancing, so it's not surprising to see so many people using the only effective measure that currently exists. Don't underestimate people's desire to not suffer a debilitating illness that leaves them unable to breathe for a week before killing them. Social distancing would be happening regardless of the official stay at home orders.
> Lots of obsessing over the current body count though.
I mean ... yeah. These are our friends, our family, our neighbors. Each one of them was a real person who is dying unnecessarily, and more deaths like them could be spared through better social distancing. This isn't "obsessing", it's a very real concern. You'd care more if it were people you knew dying. I've already had people in my extended contacts die of it (I live here in NYC), and it's rough. Hell, I already got it, and fortunately recovered. Let me tell you, spending days unable to catch your breath even just from walking is terrifying. You'd understand more if this was affecting you more personally. It's not just some abstract discussion about numbers.
So while I too am a bit skeptical of the Swedish policies it is doing pretty average on a global scale. Worse than some countries with harsh lockdown but also better than some countries with harsh lockdowns. It is too early to say for sure if the Swedish policy was stupid or not.
In Swedish news the currently most popular theory for why we have more deaths per capita than our Scandinavian neighbors is not necessarily our lax lockdown (though it may have made things worse) but lack of supplies and poor routines in old people's homes. This is of course speculation.
I don't know the particularities of Sweden, so maybe it makes more sense as you have outlined it. My apologies if that's the case!
I wonder if it's better to compare Swedens overall per-capita infection rates with other states in the US where there is a lockdown but whose capitals/major cities are more secondary cities from the perspective of international travel. Let's try North Carolina (picked for being closest in population to SE and also being not a top airport hub or travel destination compared to its neighbors) though it does have significant business and educational centers, it's probably a fair comparison to Sweden wrt population density.
NC total population: 10.5 million NC confirmed cases: 7,285
SE total population: 10.2 million SE confirmed cases: 11,445
So anyway, there are other states and countries that are doing better and worse than Sweden, but I don't think that Sweden is in any way demonstrating that it is doing better by trying to ignore the problem and possibly to blame the lack of strict enough sanitation ("lack of supplies and poor routines"), it's just coming later than to higher-volume travel centers like WA, NYC, the UK, France, Italy, etc.
In any case, the idea of doing better or worse will, in the end, be measured in per capita deaths at the end of this disaster, and we haven't gotten there yet. I truly hope that Sweden finds its way through with as few deaths as possible, but I don't think that's what they've done.
So, comparing the deaths per 10M population, Sweden is currently at 1,014, whereas North Carolina is at 114. So Sweden is suffering roughly one order of magnitude worse from the pandemic than North Carolina is at the moment. And keep in mind that North Carolina went into a shelter in place order over two weeks ago while Sweden hasn't yet, so there's a loooot more pending cases in Sweden's pipeline than NC's.
So far. It's way too early into this unfolding disaster to be making pronouncements like this while the figures are still increasing exponentially. NYC has had shelter-in-place for several weeks now while Stockholm has not. If you'd done this analysis a week ago, and then two weeks ago, you'd see Stockholm looking progressively better and better in comparison to NYC the more you go back in time. In other words, they're catching up, because here in NY we're sheltering in place and it's working, and in Sweden they aren't (yet) and thus their spread is higher.
> And Stockholm is generally more densely populated.
Not in comparison to NYC it's not, which is the fair comparison for Stockholm because Stockholm is a city whereas all of New York is a much much larger state that amounts to 1/3rd of the land area of the entirety of Sweden. NYC's density is 10,715/km2 vs Stockholm's 4,200/km2.
https://www.expressen.se/nyheter/coronaviruset/folkhalsomynd...
https://www.aftonbladet.se/nyheter/a/2Gx0Ev/fodda-i-somalia-...
Country of birth Number of cases Over-representation
Somalia 283 7
Turkiet 150 5,1
Irak 242 2,9
Finland 188 2,3
Eritrea 55 2,1
Syrien 197 1,8
Iran 83 1,8
Forna Jugoslavien 60 1,6
So pehaps this is what's been planned after all. Remember that Swedish eugenics laws lapsed only in 1976.
https://www.economist.com/europe/1997/08/28/here-of-all-plac...
The comment about the deaths being primarily in particular communities sounds like the opposite of working, though. Can you provide context regarding why it's working if people in some communities are dying?
* Edit: thanks for clarifying. I didn't realize that your comment about measures working as intended was hinting at a eugenics motives of the policymakers when I first read it, but do now.
https://www.ft.com/content/3b8ec9fe-6eb8-11ea-89df-41bea0557...
> An estimate from The Economist finds that the value of Swedish billionaires’ fortunes is equivalent to a quarter of the country’s annual gdp. Only in tax havens such as Cyprus or Monaco, or captured economies such as Russia or Georgia, are plutocrats more dominant
https://www.economist.com/briefing/2019/11/28/in-sweden-bill...
- that doctor is making a prediction about the future, based (in part) on evidence that you and I are unable to verify
- there has been no shortage of incorrect opinions and predictions from those who are genuine experts throughout this crisis
Please note that I am not disagreeing with you. Rather, I am adding benign supplementary information.
What am I missing that would imply things are about to get vastly worse there?
(I do see some other specific mistakes there that lead to a higher death rate, but I don't see the concern about things suddenly getting worse in the future)
Then what you're missing is that sweden case counting method report very low numbers (either that or their mortality rate is absurdly high, which seems more unlikely).
How is this _that_ much different from what's being done now?
Governors are forcing businesses closed or no seating allowed.
Those guidelines are good ones to maintain for perpetuity. Would decrease the thousands of flu deaths we see each year too but today's situation is closer to a nationwide lockdown than a PSA about washing hands
But at least you can still buy lottery tickets!
Additionally, my mom has been complaining about the landscapers where she lives and is angry that they're still allowed, because they flagrantly violate social distancing and get near her when she's trying to go on walks around her neighborhood.
Things are getting so bad in Detroit that bodies are piling up in unrefrigerated rooms in hospitals. Now's not really the time to be questioning if they're being too strict with the social distancing; at this point they really just do need everyone staying home, period, and not coming into contact with anyone. Motorboats and jet skis sure as hell aren't essential, and might tempt people into congregating with people they shouldn't be congregating with (boating is typically a social endeavor for example).
As for bodies piling up in Detroit... While that's true, additional restrictions added today won't have any impact there. Either the previous restrictions were sufficient, in which case Detroit should be peaking soon, or they weren't sufficient and there'll be several times that number of bodies before these restrictions start to have an effect.
My personal view is that low-risk activities should be allowed whenever possible to maximize the time period that people will willingly endure these restrictions. It looks like this won't be a sprint but a marathon, and people's willingness to comply is extremely relevant there.
Gradually increasing pressure has been the approach. It feels to me like you're right. I am willing to accept more pressure, though already burdened. It's because there's been time to adjust.
The very earliest that it makes sense to even start considering reducing the restrictions is once the healthcare system is back to operating at under its maximum capacity. And you have to ease things back slowly, ready to clamp back down if necessary if the healthcare system seems ready to be overwhelmed again.
Every incremental improvement you can do to decrease the R_0 will have its effect. Progressively stricter social distancing measures as required absolutely will work, so long as they are being obeyed anyway.
And that's MY point. How long will people be willing to obey the current restrictions? How long would they be willing to obey even stricter ones, or more lenient ones?
I don't think obedience can be assumed forever. Even China had to weld people inside their apartment buildings. And I don't know if that would be practical here.
Given that we're in the early stages of the worst pandemic to hit the world in over a century, like you, I too can't bring myself to be angry about landscaping being shuttered, or jet skis, or whatever other silly unnecessary things people are complaining about. If even one more person dies because a landscaping company opened back up a month earlier, then it wasn't worth it. And that's easily a possibility we're looking at here.
I have no idea how to quantify it, but social distancing at a grocery store, surrounded by an ever-rotating group of people, seems much more risky than a work-crew, which is composed of the same 6 people all day.
On the work crew, if one person gets it, basically everyone else on the crew is guaranteed to get it too. In the grocery store, a single visit, especially with proper precautions taken, is unlikely to spread it.
And the spread on a work crew is limited - there's only 6 people there. But that grocery store worker? Can you define super spreading event?
People wonder why others are afraid to give the government more power, this is one of the best examples of why.
Over here in The Netherlands, most supermarkets have, to various degrees, implemented measures to protect workers (plexiglass, timed restocking, etc.) and measures to encourage social distancing (reminders and lines on the floors, a maximum number of customers via a set number of carts and having an employee wipe down the carts and handing them out manually at the entrance, old-people-hour in the morning, etc.).
The psychology behind this is fascinating. It's not just the measures that help, but the fact that simply being handed a cart after passing through the turnstile puts me (and I suspect everyone else) in 'awareness' mode. I've noticed that I myself generally pay more attention to not hover around employees, and take a detour via a quiet aisle whenever I can.
This stands in contrast to all the non-supermarket stores I occasionally visit. aisles are narrower, they don't have a designated entrance-employee, and at best there's some A4 glued somewhere asking me to pay by card if I can. Not only is it more difficult to practice 'social distancing', I don't notice a similar change in 'mindset' and have caught myself more than once leaning over an employee or passing close by other shoppers. And interestingly, both myself and said shopper seemed to notice this less (in the supermarket I've noticed many more older customers wait intentionally for me to pass at an appropriate distance).
And that's not even considering weird situations like our local HEMA (a very popular convenience store) implementing a bunch of measures, but then if you want to go and pay for your stuff you have to pick up an unclean scanner gun for the self-checkout, essentially undoing any measures they implemented. Out of curiosity I stuck around to see if these 'guns' are cleaned. They're not.
I guess my point is that stores are trying to implement sensible measures but so far it's mostly been supermarkets that seem to do a decent job (even if there's quite a bit of variation between stores from even the same company). I imagine it's much easier for these chain-stores to both get expert advice /and/ implement measures nation-wide. For those who have serious concerns it's a good reason to avoid 'mom and pop' stores though.
Pick two random people Jo and Chris. If Jo wants to pass a letter from hand to hand via intermediary carriers so it gets to Chris, what’s the shortest time for it to get to Chris?
Ways to slow down the letter passing are to prevent long distance connections (close airports), slow down connections (only go to supermarket once a week), remove connections (close pubs).
To avoid any carriers passing a letter to you, you want to avoid: highly connected social people; gatherings of connected people; reduce number of meetings.
Density is one aspect, but perhaps not the most important.
One of the traits of this virus that makes it so different from past potential epidemics is that it's able to spread rapidly through a population for up to two weeks before it starts becoming "visible" (symptoms start to arrive in large enough numbers to become alarming). At the tail end of those two weeks, the infection may have spread enough to become very difficult to control.
So, if we took some kind of middle road, and then two weeks later the virus exploded, would that change how you felt about the approach?
I'm still treating this question honestly, btw. I completely agree that it would be nice if such severe measures were unnecessary and the damage to people's livelihoods could start getting addressed. But, the problem that policy-makers are dealing with is that this isn't an infection that responds well to a "wait and see" approach; by the time you start to "see" and react, you could be in deep trouble.
Wouldn't it be logical to assume this will repeat as soon as people decide it's under control again? How can you go back to normal, before everyone has caught it, and expect the rate not to go back to exponential?
The US has the highest number of confirmed coronavirus cases of any nation. The US is seeing about 2,000 confirmed coronavirus deaths a day at the moment:
https://coronavirus.jhu.edu/map.html
Contrast the US results with Australia's or South Korea's results. Australia and South Korea are doing much better.
Your statement isn't very useful. It's the per capita death rate that matters the most of any metric. It's non-sense to compare the US to countries with 5% or 20% of the population using absolute numbers.
In terms of density, it's the NYC region that overwhelmingly accounts for the problem in the US. NY + NJ = majority of US deaths. The NYC region is the most dense on population in the US, which dramatically magnified its outbreak.
Approximately 44 of 50 states have lower per capita death rates than Sweden. Most US states are doing extraordinarily well in fact.
Half of US states are seeing no serious outbreak at all.
Arizona has 7.3 million people and only 131 deaths.
Belgium has 11.4 million people and 4,000 deaths. Sweden is considered a relatively good outcome in Europe so far, they have 10 million people and 1,000 deaths. Texas has three times the population of Sweden with 1/3 the deaths.
Some more examples:
Utah 19. Oregon 55. Arkansas 30. Washington DC 67. Delaware 41. Hawaii 9. Idaho 33. Iowa 49. Kansas 69. Maine 20. Minnesota 79. Nebraska 18. New Hampshire 23. New Mexico 31. North Dakota 9. South Dakota 6. Montana 7. Vermont 29. West Virginia 9. Wyoming 1. Puerto Rico 45.
Lower population density helps a lot in most cases. However San Francisco is also one of the most dense cities in the US and only has ~15 deaths or so. That's thanks largely to climate, which impedes transmission heavily. The same reason the entire San Diego County only has 53 deaths.
The US has the 15th highest per capita death rate. It's on track to go up in that ranking:
In South Korea they all gravitated to masks very early, and they developed enough testing capacity early on to allow contact tracing to remain viable (so far).
Australia is spared for the same reason most of Latin America, most of Africa and hotter climates in Asia have been.
Nigeria, Egypt, Mexico, Argentina, Colombia, Indonesia, Vietnam and Thailand don't have such low death rates because they've been running testing at the rate of Germany and doing tracing & lockdown & testing & quarantine as well as South Korea. It's the hotter climates. It's hot in Melbourne, Perth and Sydney during the Winter in the Northern Hemisphere, ie during the outbreak so far. Melbourne has been shielded for the same reason Lagos Nigeria has been.
Australia's measures are without question further helping to limit cases. Having a warmer climate during the outbreak time while simultaneously implementing aggressive measures, is the ideal double whammy to get a good outcome. The climate makes it dramatically easier.
Indonesia is only testing at the rate of 116 tests per million people. You only find what you measure. When the rate of testing is that low you can't make any claims about the true coronavirus death rate in Indonesia:
https://www.worldometers.info/coronavirus/#countries
And it hasn't helped that the Indonesian government has been deliberately withholding coronavirus information from the country:
https://www.thejakartapost.com/news/2020/03/13/we-dont-want-...
I don't think that's true. Germany or Austria might be good outcomes. Sweden had few measures in place but their death rate is far higher than most neighbours.
The political fallout the Swedish government will face over having so much more dead than Denmark and Norway is likely going to destroy their current government and lead to a further increase of their right-wing populist party.
So yeah, there are countries that didn’t close down hard, but they look royally fucked because of it. I think the only country where the government failed where the current administration is gaining popularity is the US. For some reason.
You might be right, and I hope you are. But at least 'intuitively' my experience is that the more insular a community is, the more exposed those /within/ that community are because of frequent interaction.
So, basically, a big city is not very insular, but people spread the virus via public transit and whatnot.
A small, rural town is insular, but the locals interact much more than the city-folk. All it would take is one infected out-of-towner to trigger rapid spread locally.
I wouldn't be surprised if the problem that, for now, seems to be contained to liberal metropolises, will find their way into all sorts of rural communities because just one person passed it on. I hope I'm wrong.
I hope a side effect of the virus spread is proving wfh feasible to many skeptics. Working from home goes a long way to reducing pollution and increasing productivity and morale. It's definitely not one size fits all and doesn't work for all personalities and jobs but it should be used where it can work. At a min, it keeps people off the roads/tracks.
The problem though is that we don't know that California would somehow turn out differently, and because of this thing's damnable asymptomatic incubation period and rates of spread, by the time you realize you haven't taken it seriously enough, it's going to be very bad.
So imagine you're sitting at the table with the governor and CalOES. They're asking you to make a decision today: tank the economy, or not. In two weeks you get to see how it turned out: either you saved the economy and only several hundred people died, or several thousand people have died and your healthcare system is on the verge of collapse and the economy tanked anyway because sick and dead people don't do a lot of shopping.
Source: https://www.worldometers.info/coronavirus/#countries
Greece: https://imperialcollegelondon.github.io/covid19estimates/#/d...
Where would you rather be?
According to [0] Sweden has 11,445 cases and 1,033 deaths (CFR: 9%) as of 6pm PT 4/14. For a population of 10.3 million [1], this is a confirmed infection rate of 0.11%.
According to [2] California has 23,338 cases and 758 deaths (CFR: 3.2%) as of 6pm PT 4/14. For a population of 39.5 million [3], this is a confirmed infection rate of 0.06%.
By all accounts, Sweden is being hit far harder by this virus than California or Sweden’s own neighbors are, and based on this evidence it is reasonable to infer that the distancing measures or lack thereof have an effect on transmission.
[0] https://www.worldometers.info/coronavirus/country/sweden/
[1] https://en.wikipedia.org/wiki/Demographics_of_Sweden
[2] https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization...
There's states in the US with similar densities; I'd imagine those would be spared most of the deaths, even if stricter measures weren't implemented, but what about the coasts?
Honestly, the US, large and heterogenous as it is, should implement different measures per state. It's obvious to me that what works for some places may not work for others so well.
Given it a few more months and I suspect that the differences between the urbs and suburbs will be less.
[1] https://ec.europa.eu/eurostat/web/products-eurostat-news/-/D...
Personally I'm looking to Sweden's data, a country that instituted some social distancing measures (no crowds above 50) but not all (Restaurant dine in still open) for some clarity. Their numbers are worse than Denmark's right now but not absurdly so (2x deaths per capita).
My guess is what's going to happen is they will see more deaths, but not an unreasonable number and both sides of the debate will declare victory as they move the goal posts sufficiently.
I'm not seeing a lot of subtlety in these outcomes, nor possibility of both sides (credibly) claiming that they were right. We'll know soon enough either way.
Maybe you're being fooled by the lack of reported deaths in the weekends in Sweden? It does mess up the curve quite a bit. But it's been like that every weekend if you look at daily deaths. And it makes the log graph look less exponential than it is
Also the log graph is a day behind the reported numbers, so tomorrow you'll see a sharp rise as they're at 1200 deaths now, making it clear that it's indeed exponential
You are right though, given the numbers there's decent likelihood that it's stagnating. But there's also a decent risk that it's still exponential
In all honesty I want to do the same. But upon reflecting, that's more to do with my desire for things to 'return to normal' than anything else.
There's so much we don't know yet. What if immunity isn't a thing (I'd say unlikely) or not as binary as we think (much more likely; multiple articles I've read indicate that having a mild version of this also provides mild inoculation)?
What if the hope of the 'iceberg' theory is untrue, or very selectively true?
What if allowing this thing to roam free and cause mass inoculation also leads to mutations that mess up our plans (unlikely, from what I've read about coronaviruses).
My point is that until we have a better grasp on these potentially game-changing issues, we should prioritize study, we should prioritize testing on mass scale, we should prioritize PPE for our health care workers, and we should prioritize finding ways to minimize the consequences of our possibly-too-careful aproach.
But we shouldn't let down on that 'over-careful' approach until we know more. Regardless of the economic impact.
For some corroborating data, there's a "smart thermometer" company [1] that uses the aggregated data from their thermometers to maintain health "weather" metrics for the US [2]. Right on their health weather page, you can see a chart showing typical rates for seasonal infections across the US, up until March 1st. And if you're concerned that New York is tilting the results, then you can even zoom in to the San Francisco area [3] and see the same behavior.
Kinsa's CEO has published a writeup on medium [4] that compares a couple of different areas with different responses and timelines, and he says that the data he's seeing suggests that stay-at-home orders are making a big difference in infection rates. They have more stuff like this on their Twitter account [5].
I would think that if this were the same disease all the way back in December, the data would look very different. There'd be no explanation for the fall-off of fever rates all the way up to March 1, when it suddenly started climbing.
[1]: https://www.kinsahealth.co/
[2]: https://healthweather.us/?mode=Atypical
[3]: https://healthweather.us/?regionId=06075&mode=Atypical
[4]: https://medium.com/@inders/your-sacrifices-are-saving-lives-...
California has been spared because it's not in the Covid Belt. That's a term I've come up with to describe the ideal climate that SARS-CoV-2 thrives in. All hard hit regions exist in the Covid climate belt.
Not all the least hit areas (eg South Korea) exist outside of the Covid Belt. You can also limit its spread with other aggressive measures. Climate provides a substantial natural impediment, although it doesn't entirely stop the spread either. It's why Texas, New Mexico, Arizona look like they do right now versus Michigan and New York. It's not because Texas has had amazing testing and tracing and quarantine measures.
It's why Tehran was hammered by the virus but Baghdad was not. It wasn't luck, it wasn't testing, it wasn't tracing, it wasn't lockdown measures. Baghdad is a hotter climate than Tehran during the December > May time frame.
It's why Athens & Greece is largely spared but Milan is not. It's not because Greece implemented South Korea-style measures early on and they have a far better healthcare system than Britain. It's why Southern Italy is not hit like Northern Italy. They have different climates.
It's why Madrid is hit so hard but Barcelona and Lisbon are not. They have different climates.
It's why NYC is hit hard but San Francisco and Los Angeles and San Diego are not.
The entire San Diego County has 53 deaths.
It's why Texas is largely spared but Massachusetts and Michigan are not.
It's why Detroit was hit but Phoenix was not.
It's why Belgium and the Netherlands were hit but Mexico wasn't.
It's why Wuhan was hit but Hawaii and Jakarta and Singapore were not.
It's why Algiers (7.8m people in their metro, just south of Spain) isn't drowning in Covid cases and hasn't been hit like Madrid.
It's also why India and Pakistan have been largely spared bad outbreaks. Defying all predictions thus far to the contrary.
It's why Lagos Nigeria isn't being hit hard and the Netherlands and Britain were.
It's why Cairo isn't buried in dead bodies right now. The Cairo metro has 20 million people. Check out the temps in Cairo during the Nov > May time frame.
Look at the climates. Nearly all of the hardest hit areas exist in a sweet spot on temperature range.
Milan: https://weather-and-climate.com/uploads/average-temperature-...
Wuhan: https://weather-and-climate.com/uploads/average-temperature-...
NYC: https://weather-and-climate.com/uploads/average-temperature-...
Tehran: https://weather-and-climate.com/uploads/average-temperature-...
London: https://weather-and-climate.com/uploads/average-temperature-...
Boston: https://weather-and-climate.com/uploads/average-temperature-...
Chicago: https://weather-and-climate.com/uploads/average-temperature-...
Now compare to
Baghdad: https://weather-and-climate.com/uploads/average-temperature-...
Cairo: https://weather-and-climate.com/uploads/average-temperature-...
Los Angeles: https://weather-and-climate.com/uploads/average-temperature-...
Algiers: https://weather-and-climate.com/uploads/average-temperature-...
Lagos: https://weather-and-climate.com/uploads/average-temperature-...
Houston: https://weather-and-climate.com/uploads/average-temperature-...
Phoenix: https://weather-and-climate.com/uploads/average-temperature-...
Singapore: https://weather-and-climate.com/uploads/average-temperature-...
Las Vegas: https://weather-and-climate.com/uploads/average-temperature-...
San Diego: https://weather-and-climate.com/uploads/average-temperature-...
Athens: https://weather-and-climate.com/uploads/average-temperature-...
---
Compare Barcelona: https://weather-and-climate.com/uploads/average-temperature-...
To Madrid: https://weather-and-climate.com/uploads/average-temperature-...
Compare Milan again:https://weather-and-climate.com/uploads/average-temperature-...
To Rome: https://weather-and-climate.com/uploads/average-temperature-...
See those higher highs through the flu season? That 8-10 degrees of higher temps throughout Winter is the difference. Getting as close to the ~55-60 F or higher temp zone at the highs as possible during Winter is where you want to be. The regions that are, have seen dramatically fewer cases. This spans all variations of circumstances between nations (rich vs poor, good testing vs weak testing etc). At 64 degrees F and above, we know that influenza, for example, is heavily impeded by the heat.
This is why so many experts have been predicting a big downturn in the virus as Spring & Summer temperatures roll in.
This has already been shown by several studies. We already know why. 90-95% of all cases of transmission have occurred in the Covid Belt areas that have ideal climates for the transmission of the virus (otherwise Africa would be drowning in Covid deaths right now).
That's plainly wrong. The world has huge numbers of hot, very dense cities that have not been hit hard. The Philippines, Indonesia, Mexico, India all have obvious of examples.
Mexico City should be in extremely bad shape right now.
Check out the temps in Mexico City: https://weather-and-climate.com/uploads/average-temperature-...
Here are the top 10 most densely populated US metro zones (per the 2010 US census; population per sq mile):
Los Angeles, SF + Oakland, San Jose, NYC + NJ + CT (isolated, NYC is the most dense), Las Vegas, Miami, San Diego, Salt Lake City, Sacramento, New Orleans
Also, Riverside CA is #12, Phoenix AZ is #16. Both have been largely spared.
Now look at the per capita Covid deaths in LA, the Bay Area, Las Vegas, San Diego, Salt Lake City, Sacramento, Phoenix, Riverside. Then compare it to the Covid Belt areas.
If New Orleans hadn't made the mistake of holding Mardi Gras, they would look like other urban areas in Louisiana and the south broadly and would have dramatically fewer cases (eg Mississippi has 1/10th the deaths of Louisiana with 2/3 the population; Florida has over 4x the population of Louisiana, with half the deaths).
The Virginia Beach + Norfolk area is #22 on population density. It has so few deaths it barely registers. A couple million people live in that area, there have been only a handful of deaths. Average highs are 61 degrees F in November, around 50 from Dec > Feb, then 58 in March. ~12-15 degrees warmer than NYC throughout Winter. It never sinks into the Covid Belt ideal temperature zone, comparable to Milan, Wuhan, NYC, etc.
Check out most of the major cities in Florida. They're doing extremely well. The Jacksonville area has a dozen deaths in a metro of 1.5 million. Tampa and Orlando have done similarly well.
Because one trend I see a lot on HN is people making wild guesses about things waaaaaaay outside their area of expertise ...
I've been talking about this on HN for a while now. I've been making the same case over and over.
Guess what hasn't changed since I first floated it here? The higher temp areas I've been touting under this theory have continued to be spared compared to the Covid Belt climate areas, despite predictions by the so-called experts that everyone would be hit (the same experts that are so baffled by Texas and California). It's not testing or luck or lockdown measures or tracing. Texas did everything wrong compared to eg South Korea, they should look like New York / New Jersey / Michigan / Massachussets. It's the climate providing a big assist.
I've seen some really outlandish articles dancing around it. What crazy magic is this, that is protecting these states?!?
It's the climate.
Epidemiologists don't think so? Which ones? It's a proven fact that coronaviruses and influenza are both impeded by higher temperatures. What I'm describing makes perfect sense. We already know there is a direct correlation between higher temps and lower viability of such respiratory viruses.
From 2011 & SARS: "The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus"
https://www.hindawi.com/journals/av/2011/734690/
MIT recent observation with SARS-CoV-2: https://www.technologyreview.com/2020/03/19/905217/coronavir...
March from China: "High Temperature and High Humidity Reduce the Transmission of COVID-19"
I would want to see a very careful treatment of this data before I could be convinced that temperature is a greater factor in transmission rates than stay-at-home policies or population density. It would be really easy to cherry-pick examples.
A couple of counter-examples that come immediately to mind are Chicago and Florida. Chicago's climate should fit your model but they have about 1/3rd the cases per capita vs New York City. Florida meanwhile should be warm enough to be outside of your "Covid Belt", but cases there are expanding extremely rapidly and it's likely to overtake Washington state in per capita cases and deaths. Louisiana similarly has one of the highest per capita death rates in the nation.
Climate might be one factor, but it's not clear that it's a big factor, let alone the most important one.
My gut feeling here is that climate is not a significant factor, but that those others are. And you haven't come close to actually demonstrating it with rigor beyond it just being a guess that you have (which is fine; guesses are useful).
And you're right, the connection between climate and the spread of a disease is well known, which is why if it were relevant here there would be lots of people besides you talking about it. The articles you linked do seem to show that the virus might not survive for quite as long on surfaces at high temperatures and humidities, but that's just not really that relevant for how this disease spreads. People are primarily either inhaling droplets directly, or touching things that others have touched recently and then getting it into their face. The virus surviving for hours on a surface before being touched and then touched again to a face orifice was always on the long tail of transmission methods, so flattening that tail a little bit doesn't make a meaningful difference in the overall spread of the virus.
What happened in the exercise was that all hospitals got over run, very quickly, it took months for the infection rates to flatten.
Nobody could get into a hospital and get any proper care, entire families started dying, the death rate jumped up to almost 12%. Remember the calculated death rate is based on proper care. Police, Fire, EMS, got hit hard and they all walked off the job.
Nursing homes, assisted living facilities had death rates of almost 75%, (we’re starting to see 50% now).
Hospital workers started walking off the job. The economy didn’t slow down the economy flew into the ground at 500mph and exploded in billions of tiny pieces. The country went into immediate shortages of everything, which didn’t really matter because basically everyone stopped going to work.
When you might get sick and you know you can’t get care and without care you have a 12 in 100 chance of dying you can’t get people to leave their house, for any reason. People start dying home alone.
The death rate gets even higher because of food shortages, prescription drug shortages, and underlying health conditions fuel the fire. Power disruptions, water, sewage issue because no one is working. Crime becomes a problem, because a) the police aren’t working and b) people get desperate.
Once things start to unravel you can’t simply re-ravel things.
In a normal flu season about 40 Million people get infected, with 30-67K dead a year spread out over 6 months.
If we respond to COVID-19 like we do with the flu, we could see 150-200 million infected because it spreads more easily, those numbers would overwhelm the country, maybe have 20-35 Million dead, the economy might stop for a year or two, or three or four.
We don’t know if infection confers immunity, what happens if it doesn’t? What if getting it makes you more susceptible to a second and worse infection? What if we can’t develop a vaccine?
You’ll be gambling with a lot of lives.
> If we respond to COVID-19 like we do with the flu, we could see 150-200 million infected because it spreads more easily, those numbers would overwhelm the country, maybe have 20-35 Million dead
Even without any medical treatment at all, the death rate from COVID-19 is much lower than 13%. It might even be below 1%, once you factor in all the asymptomatic cases that we're only just starting to discover from blood antibody testing. So we're still talking about millions of deaths, which would be absolutely horrible enough in its own right, but we're not looking at double digit death numbers. COVID-19 fortunately isn't that deadly. Other diseases are though ... so in a way, as bad as this seems, we did still get somewhat lucky.
I mean, I wonder how you reach the conclusions you do? Just read your own post back to yourself. You say the numbers in SARS-COV-2 are worse than for your simulation yet the outcomes observed in reality are empty hospitals that need to furlough workers because they are so underworked. Reality has disproven the simulations, but it sounds a lot like you're concluding reality is wrong?
This seems to be a meme, but I think it started with misinterpretation of elective procedures being cancelled and employees that couldn't be repurposed being furloughed. It doesn't make any sense to equate this with hospital resources in general being plentiful. The point of no elective procedures is that some resources are freed up. Bottlenecks aren't applicable to everything equally.
How do you know though? The flat curver movement has set themselves up so there's no accountability, no reliance on data, no proof that it's working or not working. Just repeating what other people have said and patting themselves on the back that it's working.
Sweden has less per capita infections than many other countries and they have no full quarantine just basic social distancing and hand washing.
Here is some.
Graphical comparison of UK (hard lock down) with Sweden (not much lockdown e.g. restaurants and shops still open)
http://www.theblogmire.com/a-comparison-of-lockdown-uk-with-...
There's basically no difference.
Switzerland's proportion of positive tests as a fraction of all tests (i.e. is it spreading) shows no epidemic and no effect from lockdown, again, presented visually here in the tweet that's a reply to the first:
https://twitter.com/FScholkmann/status/1249703752904425478
In Switzerland the apparent reproduction number started to fall before lockdown began (see the shaded graph):
https://medicalxpress.com/news/2020-04-lockdown-impact-covid...
https://www.tagesanzeiger.ch/ansteckungsraten-flachten-berei...
(you can delete the paywall to see the headline and summary)
There are other reasons to be skeptical. Epidemics naturally come and go very quickly. The "lockdown" concept comes from epidemiologists. These people have a history of proposing extreme measures that turn out to have had no effect when compared to control groups, or when people simply realise that the epidemic entered decline before the recommended measures were implemented. If the lockdown ends up having no effect it'd be counter-intuitive but entirely predictable from how things worked out in the past. For instance, look at the history of foot-and-mouth disease in the UK.
Serious question: do you have any family, friends, or even acquaintances that you would prefer not to have 3-6 weeks of terror and complete misery with a non-trivial chance of permanent disability or death?
This is a complex issue. Using hyperbolic emotional appeals to drown out discussion is not the right move.
Maybe not doing anything would've resulted in a few months of medical chaos and not much more, maybe it would've destroyed whole societies. But the polls I'm aware of show that the majority of people is supportive of measures nearly everywhere (I'm not aware of a poll that shows the opposite). In democracies, you'd expect politicians to act if the majority and experts support it.
https://www.express.co.uk/news/world/1268263/sweden-coronavi...
https://www.dailymail.co.uk/news/article-8212365/Swedish-PM-...
The data both articles present for Sweden's death and infection rates also seem to suggest new measures might not be necessary (though admittedly the data seems pretty noisy; the recent drop in new deaths/infections could just be a fluke).
> But the polls I'm aware of show that the majority of people is supportive of measures nearly everywhere (I'm not aware of a poll that shows the opposite).
Now I don't want to speculate why people are in favor. Maybe because they believe experts but that usually doesn't work well.. I guess public opinion during the outbreak is also going to be a heavily researched area for years to come.
We'll likely get a good idea of what the "no or low response" route looks like.
With poorer countries (which applies to most of Africa), I guess it'll take several months or years until we know what the excess death rate was. Esp. in rural communities, that data probably often won't be reported as a Covid death. Even Northern Italy had an excess death rate 2x as high as the reported deaths and they had all the attention.
https://www.npr.org/2020/04/13/833623311/in-sweden-a-differe...
Society isn’t a numbers game, it’s a shared set of values, and I find it appalling that we seem to be favoring the economy over human life. We have enough resources to take care of both, but chose to bail out corporations instead of people.
I really don't agree with this meme at all and the evidence doesn't support it whatsoever. The people that are hurt most by the shutdown are lower class service workers, not Wall Street stockbrokers. As I just mentioned, everyday people are hurting far more from the lockdown than from the virus. If you really cared about the average person, you'd want to get society running as soon as safely possible.
The idea that the government can support or pay for the salary of the entire/most of the population for a sustained period of time is also completely ludicrous and impossible.
The scientific consensus seems to be that if the disease had just been left to run it's course, even with people being moderately careful given how infectious it is, it would have caused huge death figures. Perhaps that might be proved wrong when we see some countries that simply socially distanced instead of locking down, but was it ever worth the risk?
All these "well, it's bad, but look at the economic damage" have to be weighed against what could have been, not what is. And we just can't imagine this, we can say it, but how many of us can imagine 10,000s dead per day?
Your Aunt dead, a colleague dead and your best-friend's Dad dead, your Butcher's Grandmother dead, your barista's sister dead, a teacher at your primary school dead, your football team's goalie dead. And more, and more. Of the few hundred people you know you would have known several people who would have died, or the thousand or so you are a 2nd connection to you would have heard of many deaths.
On top of that all, New York and the UK only really have Italy and Spain to look at as any sort of predictor. They now have to watch just two countries to see what happens when they start easing the restrictions, and due to the massive lag between infection and hospitalisation/death and insufficient testing capacity, it's all still guess work.
Lift it a week or two too early, and you might have to go into another lock down in a few months time.
Also, don't forget death rates would go up if a healthcare system collapses, which we haven't seen.
I think you're the delusional one, while your personal chance of dying is fairly low, you know hundreds of people, and those people know thousands more.
That is really the only question that matters.
"The Office for National Statistics said that in the week to 3 April, 16,387 people died in England and Wales, an increase of 5,246 deaths compared with the previous week and 6,082 more than the five-year average."
And that's WITH a lock down, way before the massive peak that could have happened.
It's like you're stuck in the wishful thinking stage the rest of us were in two months ago.
Also, you’ve responded several times without answering my question:
How many of your family, friends, and acquaintances are you willing to put up for the experiment?
> How many of your family, friends, and acquaintances are you willing to put up for the experiment?
This kind of snarky comment is precisely the problem. I'm not "willing to put up my friends" for experiment, because this isn't some zero sum game with simple answers. As I have said a dozen times now: it is a complicated situation and this "but people are dying, so we have to be as draconian as possible" take is extremely shortsighted.
There are millions of people that will now have serious problems because of the total shutdown. Here's a number for you:
> 45,000 – or one in five – suicides a year worldwide to unemployment, with a further 5,000 deaths caused by the economic crisis.
https://www.weforum.org/agenda/2015/02/the-link-between-unem...
45,000 people a year kill themselves because of unemployment. And that's just after 2008. We are apparently headed for a far worse crisis.
Have you considered the possibility that completely shutting down everything for months on end will result in more chaos and death than the virus itself? Even worse, this is entirely unpredictable?
As I said above: it's a complex issue. The consequences of shutting the world down just might be worse than the death toll of COVID. At the very least, it's a discussion worth having.
And "it's not a hyperbole" does not mean "it's not a complex issue" or "the alternative is better" or "it's not a discussion worth having". By all means, have your discussion. Point out that it's a complex issue like you already did. And if you dispute the claimed facts, dispute them and bring your own facts. If you don't, then just don't falsely accuse people of exaggerating them. Don't sling mud at factual arguments made in good faith; it's not difficult for others to reciprocate.
But isn't that what you just did here?
> Do you understand that millions of people are now out of work and won't be able to support their families, businesses are collapsing, calls to suicide lines are up massively, and society is general is not functioning?
So let's do some math instead.
The last stats I had were that 5% of people who catch it will die without a ventilator, 0.5% will die with it. So suppose we go "fast burn" to try to get "herd immunity" as quickly as possible, forget about overwhelming the health care system. 80% of your friends, family, acquaintances, and coworkers will catch it, and 5% of those will die.
I reckon most people have about 500-1000 people they feel connected to. So think about your network: which 20-40 people do you want to die so that the rest can go back to work?
No, because I'm not drowning out the discussion, simply pushing back on the usage of hyperbole for pushing an opinion.
> The last stats I had were that 5% of people who catch it will die without a ventilator,
Your stats are way off and I suggest doing better research. They also don't factor in the idea that the virus is far more widespread than initially thought, and that these death rates only account for people that are sick enough to get tested in the first place.
I've been reading [1] daily more or less since early February, as well as lots of things posted here. I'm certainly no professional, but I think I'm reasonably well-informed for a layperson. If you think there's something I've missed, I think you'd do much better to actually point me to a resource you think is better.
I realize that "number reported" is an issue, and varies a lot from country to country. But consider Germany, who have [EDIT: ramped up to 400k+ tests per week] now. The most recent numbers from the situation report says that Germany has 125k reported cases, with 3k reported deaths -- a death rate of 2.3%. EDIT: Also consider Korea, which is alleged to have instituted a massive testing infrastructure as well. Their numbers are currently 10,564 cases, 222 deaths -- again, 2.1% death rate.
It's possible that both the German and Korean numbers of cases are massively underreported, but it can't be by much. That puts the death rate with non-overwhelmed hospitals at significantly higher than 0.5%.
If you want to convince me that the death rate for overwhelmed hospitals is less than 5%, you're going to have to do better than waving your your hands and saying "but what about people not sick enough get tested".
EDIT2: Been challenged on the "500k tests per day", acknowledging that while I look for support for that claim.
EDIT3: I slightly mangled my numbers from [2]. The numbers from that are that Germany has been doing 160K tests per week since 20 March; and that the government's goal is 200k per day. [2] According to [3], on the week ending April 5, Germany did 393k tests.
[1] https://www.who.int/emergencies/diseases/novel-coronavirus-2...
[2] https://www.spectator.co.uk/article/how-germany-has-managed-...
> And the total number of swab tests done by 4 April was well over 1.3 million.
https://www.bbc.com/news/health-52234061
The population of Germany is 83 million. I find it hard to believe that they've tested more than 5 million or so people in 10 days.
The only way to get the "die with the best medical care" number below 0.1% is if you have a million untested people who are sick.
If I was a proper statistician, with those numbers I could probably come up with models or estimates of how many possibly untested people there might be in Germany. My instinct is that number can't be millions, because at least some of those millions would be sick enough to go to the hospital, and then all of their connections would be tested and be found out.
But even then, what we really need is the "would have died without medical care" number, which is what the number would look like if we did a "fast burn" and let everyone get sick at once. For that number to be less than 1% (which would still be pretty dire), we need closer to 2 million unknown cases. I just don't see how 2 million positive cases can hide from the kind of testing Germany is doing. The same goes for Korea.
[1] https://www.who.int/docs/default-source/coronaviruse/situati...
Hospitals being overwhelmed is an exaggerated problem. It's not happening in many places. Most hospitals only need to provide a small amount of care and can actually scale this up rather quickly. You hear about people being triaged in Italy, but you need to remember that the people being triaged are likely to die regardless of whether or not they're admitted to the hospital. Averages are not your friend here. If 50% of ICU patients survive, that does not mean that everyone going into the ICU has a 50% chance of surviving. If we get to a point that triaging is needed (I think dubious in major US cities), that does not mean fatality rates will skyrocket.
Social distancing has been pretty darn effective, and it's probably a good idea to cautiously continue. But we also need to be pragmatic.
...because people are introducing restrictions to keep the number of cases down.
> Your mental model is mostly meaningless. ...Social distancing has been pretty darn effective, and it's probably a good idea to cautiously continue. But we also need to be pragmatic.
Ok, but at least mine I told you what the exact numbers are and where they came from. What are your numbers, and where did they come from?
You can't not have a model: you can either have an explicit one that you can reason about and question, or you'll have an implicit one you can't reason about or question.
You've waved your hand about why 5% death rate for a "fast burn" scenario is probably not exactly the precise number. I never said it was; but I think there's a pretty good chance it's in that ballpark.
You, on the other hand, haven't said what you think the death rate for a "fast burn" will be.
It is IRRESPONSIBLE to recommend a course of action without thinking through the consequences. Just wishing that 5% of people won't die isn't going to prevent those people from dying.
I'd like a 0.001% fatality rate in a "fast burn" scenario as much as anybody. If you can convince me that's a good number, I'll go around and try to convince others. Until that time, I'm going to continue going with the best guess I have, and a guess which lots of experts seem to be making as well.
I mean, yes, I do agree that social distancing is a good idea and that we should continue to do so. I acknowledged that much. But my real point here is that hospital capacity can scale up significantly higher than you might assume. Average level of care goes down for each person, but that's mostly fine. We can't treat people for this disease, so all the hospitals are doing is trying to keep people alive long enough to get over it themselves. A half hearted benefit of this is that since there isn't much you can do, you don't have to do much to help people as best as possible.
> Ok, but at least mine I told you what the exact numbers are and where they came from. What are your numbers, and where did they come from?
When I say your mental model is meaningless, I'm referring to "which 20-40 people do you want to die so that the rest can go back to work". You're thinking in averages, and that's not the case. The CFR of any population is going to be determined, foremost by the age distribution. I don't know if this is still true, but a while ago the CFR in italy was lower in every age group relative to China but worse overall due to age group differences and simpsons paradox. The concept of death rate is truly meaningless. I'm not saying you're wrong, I'm saying its a pointless discussion. But sure, range of 0.5%-7% for a randomly chosen locale. Less than 1% average for those under 60 years old across the board.
For the record, I don't think rushing to herd immunity makes sense either, but there is a middleground.
> It is IRRESPONSIBLE to recommend a course of action without thinking through the consequences. Just wishing that 5% of people won't die isn't going to prevent those people from dying.
I think its pretty naive to say it's irresponsible to not have explicit threats on the disease but hand wave explicit threats on the economic consequences. I think it's better to let a 90 year old person die than to throw a 20 year old into poverty personally. Globalism is complicated. Depressions can cause famines, the rise of violent authoritarianism, and just general despair even if your particular society holds together. Poverty sucks, and it disproportionately hurts people who are already poor or in poor countries.
I presented you a model; yes it's oversimplified, but it results in at least some sort of concrete answer; and you can actually examine where it came from and reason about how valid it is. You can make arguments for some other death rate or herd immunity rate. (I took 80% from the most recent article I heard on the subject, but previously I heard 60%.)
You also actually have a model in your head for how many people are going to die (or not die). But I don't know where it came from. I can't examine it or reason about it. If you were an old-timer who'd seen hundreds of pandemics, or a historical epidemiologist who had studied hundreds of epidemics, maybe your "gut feel" would carry some weight.
But since (AFAICT) you're a layperson like me, I'm not inclined to think your implicit model is going to be very accurate.
You will have bodies abandoned in the streets, like in Ecuador.
Also it's only what is reported. There could've been a million people with it in the US but nobody knew...and still don't.
I really agree that we used a tsunami to put out a campfire. There was no reason to close everything basically. If this was like a 25% mortality rate of all those who got it, then yeah, the response would've been appropriate. This is like less than a percent for the majority of the population, a few percent for infants, and a few extra percent for old people. Which already have been at risk just for the sake of being old.
This whole event is just the media at large and social media blindly following as well overexaggerating this "crisis." 2008 was a crisis cause a bubble burst and banks defaulted. This was something made up that really did not need to be this drastic.
Unless you want to force people to eat at restaurants, travel to conferences, host events, etc...
[0] there's this from March 13, for instance https://blog.opentable.com/2020/covid-19-coronavirus-restaur... , googling conference cancellations and such is left as an exercise for the reader...
Here's the data out of new york city. You can see the chart showing hospitalizations and deaths per age. The trend is pretty biased towards old people. This makes me wonder if a more targeted response by the government would be better. The 2 trillion dollars might have been better spent. https://www1.nyc.gov/site/doh/covid/covid-19-data.page
> Covid for new york city has a death rate of about 75 per 100k.
So far. We're still experiencing hundreds of deaths per day in the city, significantly more than all other causes combined. Your analysis is vastly premature.
Even if it's 150 per 100k, or even if it's 500 or 1000 per 100,000, is that too much? We need to establish an upper bound for the number of deaths we're willing to tolerate. It cannot be "zero". There is a balance between acceptable mortality and economic consequence that I fear few people are willing to discuss. The medical establishment's goal is to save as many lives as possible, and due to that strategy, they will go to any length to make that happen. I do not once see a medical professional saying "well we can't save all these lives because it would be too expensive". The concession seems to only go one direction: The economy must suffer at any and all cost to minimise mortality as far as possible.
So again, what is an acceptable mortality rate? 2%, 5%? A realistic upper bound that's a fair trade off between economic collapse and mortality rate needs to be decided.
Also I think that setting an acceptable death rate is missing the point; depending on the illness anything between 0% to 100% is "acceptable" if there is nothing we can do. A more appropriate measure (IMHO) would be a something vaguely like lives_saved^2/effort.
In particular this need to consider the famous flattening the curve and the fact that for some categories of people the mortality rate can be very high.
On the other hand (and also on a more amoral side) it would be interesting how many alive man-months COVID-19 destroyed, as in how long was the average life expectancy of the people that died from it. I feel like this would be both harder to measure and more significant in term of sociological damage.
(in general this kind of conversations are hard as it is easy to insinuate that old people have less value which is both completely false and somewhat true, I personally do not possess the talent of walking this fine line of language)
Sounds good. After all, death is irreversible while economic damage is not.
>So again, what is an acceptable mortality rate?
I'd phrase it more like a flattened curve. Rather than focus on a specific mortality rate, the bound to reopen the economy should be something along the lines: when the curve is flattened enough so hospitals can deal with the incoming infection rate. So this would be local to an area (city size, maybe regional) and would also adjust based on local conditions. Infection rate low enough, open the economy a bit more. Infection rate trending up, close the economy a bit more.
If that doesn't result in economy numbers that make the billionaires happy, too god damn bad.
Maybe free market uber capitalistic unregulated invisible hand economic theory needs to be rewritten or adjusted for new realities, including a section on why exactly lower wage workers (retail, service) are expected to risk their lives so the economy built on top of them, the one in which the rewards mostly go elsewhere, can function.
https://www.nytimes.com/video/opinion/100000007076660/corona...
There's no way to disprove it.
The gist is that this is more like avoiding rock climbing because you don't want to fall to your death. It's not likely that you fall to your death rock climbing, but it is MUCH less likely if you never climb. But, you can't know the future, so you can only take actions that are either right or wrong in hindsight.
There's already been huge economic impacts, and everyone seems to assume once this is all lifted things will be normal. But without a vaccine or systematic antibody testing, will we just end up delaying the worst of the virus?
My fear is one of two things will happen: either we will have done all this economic slaughter with the lockdowns and still end up with the direct effects of the virus, but delayed, because of lack of herd immunity; or we will do this indefinitely and the economic casualties will increase proportionately.
I'm not saying the lockdowns are or are not the wrong thing to do, but I do feel like doing them without a clear plan for getting out of them is. I also feel like in the absence of these plans, its unfair to compare no-lockdown policies to lockdown policies in current casualties because those places may just be experiencing pains that lockdown locations have temporarily avoided. Places with lockdowns too late may unwittingly be similar.
You do realize that there are so few cases because of the lockdown, and otherwise those cases would not only be an order of magnitude higher, but also much much MUCH more likely to result in death because the medical system would be entirely saturated and unable to admit 80% of the people who show up ?
An order of magnitude is a week of the natural virus spread. How long has been the lockdown there? Two weeks would mean imply in a two orders of magnitude difference.
If we had not done that we'd probably look more like New York right now.
The more effective your measures are, the more it is going to look like they were unnecessary.
Or to reuse your metaphor: A campfire can turn into a wildfire really quickly. If we hadn't thrown the tsunami onto it when it was the size of a campfire, we might have gotten a wildfire burning down the whole state.
Acting early enough trumps everything else.
On the other extreme case there might be so few cases that there will be zero herd immunity in September and a second even worse lockdown might be needed again.
This is based on a collapsed health care system causing the vast majority of cases requiring ventilators to result in death.
Roll two die, if you roll snake eyes you would die.
But, in my experience, most people saying things like "cure cannot be worse than the disease" are young, healthy and have access to good health care. Would that describe you? My father is in the 18+% fatality zone.
Also, California ICUs are at 80% capacity, so there isn't that much room left to relax unless you want them to get verwhelmed and start sending people back home to die.
From https://www.sacbee.com/news/local/health-and-medicine/articl... :
> About 1,178 confirmed and 374 suspected COVID-19 patients were under treatment in California’s ICUs on Tuesday, according to the latest figures from the California Department of Public Health.
> On a typical day, about 58 percent of the state’s ICU beds are occupied by patients needing treatment. Although the exact number of ICU beds currently in use was not released, the increase in COVID-19 cases suggests that about 80 percent of the ICU beds in California may now be filled.
And from https://www.mercurynews.com/2020/03/24/map-where-are-the-int... :
> In California, where the confirmed number of coronavirus cases was 2,181 on March 23, there are 7,345 ICU beds. Eleven counties have no ICU beds or no hospitals at all.
https://www.worldometers.info/coronavirus/country/sweden/
https://www.worldometers.info/coronavirus/country/norway/
Will be very interesting to follow during May, as Norway is now opening up again. Schools and kindergartens will start again next week.
The reason California has such few cases was because it acted sooner.
Next you will be telling us about Y2K.
It's only a waste if you need to waste it. I'm sure plenty of people are using this time to be productive doing things they would otherwise not have the time to do.
[1] https://www.epa.gov/environmental-economics/mortality-risk-v...
[2] https://www.huffpost.com/entry/financial-crisis-cost-gao_n_2...
[3] https://foreignpolicy.com/2020/03/18/coronavirus-economic-cr...
[4] https://www.youtube.com/watch?time_continue=58&v=v_-ZY1QAr2g
Ignoring the economics, preserving life takes on new meaning if you count a every locked down day as taking away an hour of life from someone. Take the Bay Area. At 7.7M people, every day, there are 11.7 lifespans wasted by lockdown. There have been 3.2 covid-19 deaths per day.
So, take heart in this at least?
RNA viruses have a faster mutation rate than DNA viruses.
Chickenpox = DNA virus, Coronavirus = RNA virus.
That Chickenpox is a DNA virus is why, like HIV, it can survive in the body for the long term and re-emerge decades later as shingles. DNA has a double helix which has error-correction and is more stable. However that makes it also physically larger and more complicated. RNA is small, sloppy, and cheap.
Source of all this: Spillover, David Quammen: https://www.amazon.com/Spillover-Animal-Infections-Human-Pan..., it's a good & topical book, a little bleak but good. There's a discussion of exactly this about halfway through the book.
So I do not believe your comment is factually correct. Sadly, the COVID-19 causing virus should have a high potential mutation rate similarly to all RNA viruses.
https://en.wikipedia.org/wiki/Common_cold https://en.wikipedia.org/wiki/Coronavirus
Still, "the Coronavirus" COVID-19 causing virus is an RNA virus correct? Those mutate rapidly & in fact, evading immune systems via rapid evolution, is part of what has allowed RNA viruses to exist & thrive.
This fact of being an RNA virus, might be one reason that making a vaccine is difficult & that long term immunity is in question: https://en.wikipedia.org/wiki/RNA_virus#Mutation_rates
> Preliminary analysis of COVID-19 indicates that catching it once is likely to confer life-long immunity.
I wasn't able to find this in your links. Regardless, I hope that is the case.
And I'm nothing close to an expert on any of this. But refer to sources, e.g.:
https://www.businessinsider.com/new-coronavirus-mutates-slow...
https://www.washingtonpost.com/health/the-coronavirus-isnt-m...
Thanks for sharing -- great link, I learned something, thank you.
I wonder if any models take into account the availability of drugs. I wonder because (perhaps because I studied pharmacology back in the days) while not effective as a vaccine, proper clinical management of this disease with drugs would help a lot in helping hospitals.
Instead the media seems only to focus on a vaccine (which is putting all eggs in one basket, if it fails).
Currently, there are a number being tested by WHO and other trials, I list the ones that come to mind:
- remedisivir (repurposed anti-Ebola drug): several trials to end by May-June
- lopinavir/ritonavir (anti-HIV drugs): those delivered bad results in a recent study, but those so far were (a limitation noted by the study authors) on patients with rather severe sympthoms, so it's still undecided whether they're effective or not
- Chloroquine family (chloroquine/hydroxychloroquine, with or without azithromycin): some preliminary studies may have shown interesting effects, but there were small sample sizes (also in another study which apparently was not very successful). U of Minnesota started a largish (3000 people) trial to see if it's prophylactic for immediate post-exposure to the virus. Another one started a couple of days ago to test the combination with the antibiotic (whose reported purpose is to fight off secondary infections)
There are others with less spotlight such as favipiravir, which provided a (modest) improvement in a small trial in China, and it's now part of a Phase 3 trial in Japan, or whole classes of drugs to combat the secondary but clinically important sympthoms like overinflammation (which occurs in some patients) like tocilizumab.
A lot of eyes are pointed on the chloroquines because they are already available (although they do present significant side-effects).
Neither of these drugs (or many others, see for example https://biocentury.com/coronavirus for some lists) will likely provide miracles. What the trials will do (hopefully!) is to help understanding how early they must be taken, and how effective they are in clinical management. An advantage, however, is that they will be available faster than a vaccine (modulo some non trivial issues like mass production).
I’m predicting that we will panic at the financial numbers, open things up in June and then this fall there will be a bigger second wave, hopefully we stock the pantry with PPE and everything the medical professionals need in the mean time. It will be a Hail Mary, hoping we can get a vaccine in to play by September
It seems to be forbidden to debate this unfortunately.
You’d have to find somebody to debate with, however, and most people are not particularly interested in “hang your Grandma for my stocks”. That is not a restriction of debate, it’s the social dumpstering of people beyond either statistics or empathy and that’s a feature and not a bug.
I shall not buy what you are selling.
The stakes are not "my stocks". The stakes are civil society, which as you may or may not know, can't exist for long without a functioning economy.
We must take care of each other, it is our basic obligation as citizens of a civil society, and this is the only way we can do that right now.
We don't live in a vacuum. Economic activity is not some cute thing people do in their free time. Recession also costs lives, including those of some grandmas.
But instead what we get is "the economic effects aren't worth it" where none of the assumptions are quantified.
But people feed their children using the value of their stocks.
Do you think it's possible that a seriously damaged economy will lead to more suffering and deaths than are being prevented by the lockdown?
Why is it so wrong to ask 'are we sure we're going the right way - this way seems to have a lot of problems - are we sure the other way has more?' Some people literally kill themselves when they become unemployed. We have millions of new unemployed people.
You say it's not forbidden but you're comparing me to a turd for doing it. Why does it cause people to abuse me?
This is my last message in this subthread because your misreading of my post to put on a hairshirt has convinced me that you are not here to discuss the topic in good faith. HAND.
There isn't a country on Earth right now that isn't doing social distancing of one form or another. It's an inevitable consequence of a pandemic; it's not some elective choice that we made.
That said; the economy taking a dive is preferential to the population doing the same. There will always be work to be done as long as we wake up every day; and the trick is figuring out how to adapt to new circumstances to get that done.
For instance, now would be a fantastic time to train additional medical personnel or build additional infrastructure for them. Research efforts into mitigating the pandemic are also highly desirable. Logistics solutions to enable financial compensation and product dispatch from community kitchens restauraunts, etc without necessitating physical congregation are sure bets, and just about anything that isn't dependent on getting a bunch of people all in the same place at the same time is also good.
The economy is perfectly fine if you don't assume there is an implicit guarantee that the same endeavors that were profitable yesterday must remain so always. What we're experiencing is an economic record scratch and pivot.
Perhaps for a while most actual economic transactions will be centered on "because it needed to be done, and the government is subsidizing everything until we can find a way to get private enterprise running freely again." Who cares? Life'll have to keep going. If a Jubilee has to happen to reset things... Oh well. It'll suck; but no one asked for this.
The type of work to have people thrown at it is what has changed, and the acceptable methods of execution have been altered. I doubt we'll see a wholesale collapse of civilization by a long shot. What'll be far more interesting to see is if we'll weather the transition to less globalised work smoothly or not. The predictability of life just took a hit; that's all. Time to show how to change. No?
Are widespread food shortages in six months realistic? I guess we'll see.
Food shortages don't appear to be realistic and hinge on assumptions that don't seem to hold water.
I could be wrong, but I'm going to guess you have no idea what you're talking about on this particular topic.
It is often of this sort of "I feel that the economic costs will be worse than the human life costs" without any hard backing to explain that. Challenging the opinions of the people getting airtime is fine, but only if you've got the material to back you up.
Otherwise it sounds just like wishful thinking.
https://www.nber.org/papers/w23192?fbclid=IwAR15UAkVuakNeQrl...
100,000 more drug overdoeses per 1% unemployment
Also https://www.webmd.com/depression/news/20110414/suicides-go-u...
...what? Who would wish for this? Maybe you're pattern-matching to something for which you have a political response, without actually listening to the worry that is being expressed.